ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Association Between Preoperative Platelet Count and Transjugular Intrahepatic Portosystemic Shunt Procedure-Related Hemorrhage in Cirrhotic Patients: A Retrospective Study
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
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Objective: Transjugular intrahepatic portosystemic shunt (TIPS) is a high-bleeding-risk vascular intervention. The association between TIPS-related hemorrhage and preprocedural platelet (PLT) count remains unclear. Methods: This was a retrospective cohort study including patients receiving TIPS procedures for complications related to portal hypertension due to liver cirrhosis between 2011 and 2022. Logistic regression and subgroup analyses were performed to evaluate the relationship between TIPS-related hemorrhage and preprocedural PLT count. Patients were divided into two groups based on a PLT threshold of 50 × 109/L. Furthermore, patients with PLT count < 50 × 10⁹/L were stratified into two subgroups based on a threshold of 20 × 10⁹/L. The primary endpoint was TIPS procedure-related hemorrhage. Results: A total of 632 patients with liver cirrhosis who underwent TIPS were categorized into two groups based on their PLT counts of 50 × 109/L. The incidence of TIPS-related hemorrhage was 2.8% in the PLT < 50 × 109/L group (n = 417) and 1.9% in the PLT ≥50 × 109/L group (n = 215) (95% CI: 0.23-1.97; P = 0.480). In subgroup analysis, the bleeding rate was 0% in PLT < 20 × 109/L group (n = 10) and 2.9% in PLT 20-50 × 109/L group (n = 205). No statistically significant intergroup differences in bleeding rates were found (95% CI: 0-9.7; P = 0.501). In the univariate and multivariate analysis, advanced age is the independent risk factor for TIPS-related bleeding (OR = 1.054, 95% CI: 1.006-1.105, P = 0.028). Conclusion: This study revealed that preoperative PLT count is not associated with TIPS procedure-related hemorrhage in patients with cirrhosis. Patient age should be carefully considered in the preoperative assessment.
Keywords: cirrhosis, Transjugular, Intrahepatic, Portosystemic, shunt, procedure-related, Hemorrhage, Thrombocytopenia
Received: 08 Sep 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Li, Xu, Quan, Wei, Tai and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yang Tai, tyscu@foxmail.com
Hao Wu, hxxhwh@163.com
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