Spleen stiffness measured by sound touch elastography predicts survival after TIPS in patients with cirrhosis

Transjugular intrahepatic portosystemic shunt (TIPS) is an effective procedure for managing portal hypertension-related complications. Liver and spleen stiffness may noninvasively predict post-TIPS survival. The aim of this study was to establish a predictive model that integrates elastography parameters and other noninvasive markers to predict survival in patients after TIPS. This was a single-center prospective study. A total of 89 patients who underwent the TIPS procedure in our department between July 2021 and December 2023 were enrolled. Liver and spleen stiffness were assessed using sound touch elastography before the TIPS procedure. The primary outcome of the present study was patient mortality, and the secondary outcome was further decompensation after the TIPS procedure. Kaplan-Meier curves were used to analyze mortality risk across groups. A total of 39 patients (43.8%) developed further decompensation. Spleen stiffness and liver stiffness, were significantly higher in the further decompensation group than in the non-decompensation group (34.16 vs. 26.12 kPa and 16.59 vs. 14.7 kPa, respectively). However, there was no statistically significant difference in liver stiffness. The cutoff value of S-STE for predicting further decompensation was 35.27 Kpa. The cutoff value for S-STE for predicting mortality was 36.435 kPa. Using a Child-Pugh score threshold of 9.5 and an S-STE value of 36.435 kPa, patients were classified into good, moderate, and poor prognosis groups. The mortality rates were 2.0%, 77.8%, and 29.0%, respectively. Kaplan-Meier curves revealed a significant difference in mortality among the three groups (log-rank: p < 0.001). S-STE is a noninvasive imaging modality. An S-STE value of 36.435 kPa combined with a Child-Pugh score of 9.5 provides a risk-stratification predictive model for patients after TIPS. This approach may assist in the clinical management of these patients. Not applicable.