Risk factors for rebleeding at different time points after TIPS in cirrhotic patients with AEVB: A case-control study

This retrospective case-control study aimed to identify risk factors for early (≤6 weeks) and late (>2 years) rebleeding after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients with acute esophagogastric variceal bleeding (AEVB). A total of 208 consecutive patients who underwent TIPS for AEVB at a single tertiary center between January 2021 and December 2023 were enrolled and followed up until May 2025. Multivariate logistic regression was performed to determine independent predictors of rebleeding at different time points. During follow-up (mean 20.06 ± 9.53 months), 12 patients (5.8%) developed early rebleeding, and 21 (10.1%) had late rebeeding. Multivariate analysis showed that elevated preoperative fasting blood glucose (FBG) was an independent protective factor against early rebleeding (OR = 0.861, 95% CI: 0.765-0.969, P = .013). For late rebleeding, male gender (OR = 3.820, 95% CI: 1.069-13.651, P = .039) and preoperative infection (OR = 6.490, 95% CI: 2.389-17.631, P = .001) were identified as independent risk factors. Higher preoperative FBG is associated with lower risk of early rebleeding after TIPS, whereas male gender and preoperative infection predict an increased risk of late rebleeding. These findings may help risk stratification and perioperative management in patients undergoing TIPS for AEVB.