Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://gr.elmerpub.com

Original Article

Volume 000, Number 000, July 2026, pages 000-000

Understanding the Relationship Between Sarcopenia and Perioperative Outcomes Among Patients Undergoing Transjugular Intrahepatic Portosystemic Shunt: A Nationwide Analysis (2016–2022)

↓ Figure 1. Inclusion criterion flowchart for patients undergoing TIPS included in the study. TIPS: transjugular intrahepatic portosystemic shunt.

↓ Figure 2. Distribution of outcomes in post-TIPS patients with and without sarcopenia. TIPS: transjugular intrahepatic portosystemic shunt.

↓ **Table 1.** Demographics of the Population Included in the Study
	Absence of sarcopenia, n (%)	Presence of sarcopenia, n (%)	P-value
Age categories			0.34
18–44	2,275 (14.1)	500 (14.3)
45–65	9,150 (56.8)	1,895 (54.0)
> 65	4,675 (29.0)	1,115 (31.8)
Sex			0.05
Male	10,200 (63.4)	2,085 (59.4)
Female	5,900 (36.6)	1,425 (40.6)
Race			0.29
White	11,575 (71.9)	2,485 (70.8)
African American	655 (4.1)	170 (4.8)
Hispanic	2,800 (17.4)	585 (16.7)
Asian/Pacific islander	295 (1.8)	95 (2.7)
Native American	235 (1.5)	80 (2.3)
Other	540 (3.4)	95 (2.7)
Primary expected payer			0.43
Medicare	6,245 (38.8)	1,420 (40.5)
Medicaid	3,950 (24.5)	940 (26.8)
Private	4,555 (28.3)	870 (24.8)
Uninsured	745 (4.6)	170 (4.8)
Median household income			0.94
Lowest quartile	5,235 (32.5)	1,115 (31.8)
Second quartile	4,190 (26.0)	895 (25.5)
Third quartile	3,750 (23.3)	850 (24.2)
Highest quartile	2,925 (18.2)	650 (18.5)
Charlson Comorbidity Index			< 0.001
0	1,005 (6.2)	125 (3.6)
1	590 (3.7)	40 (1.1)
2	5,310 (33.0)	1,145 (32.6)
3	9,195 (57.1)	2,200 (62.7)

↓ Table 1. Demographics of the Population Included in the Study

Absence of sarcopenia, n (%)

Presence of sarcopenia, n (%)

P-value

Age categories

0.34

18–44

2,275 (14.1)

500 (14.3)

45–65

9,150 (56.8)

1,895 (54.0)

> 65

4,675 (29.0)

1,115 (31.8)

Sex

0.05

Male

10,200 (63.4)

2,085 (59.4)

Female

5,900 (36.6)

1,425 (40.6)

Race

0.29

White

11,575 (71.9)

2,485 (70.8)

African American

655 (4.1)

170 (4.8)

Hispanic

2,800 (17.4)

585 (16.7)

Asian/Pacific islander

295 (1.8)

95 (2.7)

Native American

235 (1.5)

80 (2.3)

Other

540 (3.4)

95 (2.7)

Primary expected payer

0.43

Medicare

6,245 (38.8)

1,420 (40.5)

Medicaid

3,950 (24.5)

940 (26.8)

Private

4,555 (28.3)

870 (24.8)

Uninsured

745 (4.6)

170 (4.8)

Median household income

0.94

Lowest quartile

5,235 (32.5)

1,115 (31.8)

Second quartile

4,190 (26.0)

895 (25.5)

Third quartile

3,750 (23.3)

850 (24.2)

Highest quartile

2,925 (18.2)

650 (18.5)

Charlson Comorbidity Index

< 0.001

1,005 (6.2)

125 (3.6)

590 (3.7)

40 (1.1)

5,310 (33.0)

1,145 (32.6)

9,195 (57.1)

2,200 (62.7)

↓ **Table 2.** Decompensation, Procedures, and Comorbidities Stratified by the Presence of Sarcopenia
	Absence of sarcopenia, n (%)	Presence of sarcopenia, n (%)	P-value
*P < 0.05. MASLD: metabolic dysfunction-associated steatotic liver disease.
Decompensation
Ascites	10,505 (65.3)	2,815 (80.2)	< 0.001*
Hepatorenal syndrome	820 (5.1)	525 (15.0)	< 0.001*
Hepatocellular carcinoma	460 (2.9)	130 (3.7)	0.24
Spontaneous bacterial peritonitis	410 (2.5)	280 (8.0)	< 0.001*
Variceal bleeding	5,585 (34.7)	1,140 (32.5)	0.28
Hepatic encephalopathy	1,145 (7.1)	520 (14.8)	< 0.001*
Procedures
Esophagogastroduodenoscopy	5,450 (33.9)	1,275 (36.3)	0.22
Blood transfusions	4,125 (25.6)	900 (25.6)	0.99
Mechanical ventilation	3,300 (20.5)	975 (27.8)	< 0.001*
Renal replacement therapy	540 (3.4)	275 (7.8)	< 0.001*
Etiology of liver disease
Alcohol-related liver disease	7,900 (49.1)	1,820 (51.9)	0.19
Hepatitis C	2,695 (16.7)	545 (15.5)	0.41
Hepatitis B	255 (1.6)	120 (3.4)	0.001*
MASLD	4,960 (30.8)	875 (24.9)	0.002*
Budd–Chiari syndrome	190 (1.2)	40 (1.1)	0.93
Cholestatic disease	495 (3.1)	125 (3.6)	0.52
Autoimmune hepatitis	285 (1.8)	85 (2.4)	0.30
Comorbidities
Congestive heart failure	1,435 (8.9)	425 (12.1)	0.006*
Cardiac arrhythmias	2,150 (13.4)	610 (17.4)	0.004*
Chronic renal failure	2,670 (16.6)	765 (21.8)	0.001*

↓ Table 2. Decompensation, Procedures, and Comorbidities Stratified by the Presence of Sarcopenia

Absence of sarcopenia, n (%)

Presence of sarcopenia, n (%)

P-value

*P < 0.05. MASLD: metabolic dysfunction-associated steatotic liver disease.

Decompensation

Ascites

10,505 (65.3)

2,815 (80.2)

< 0.001*

Hepatorenal syndrome

820 (5.1)

525 (15.0)

< 0.001*

Hepatocellular carcinoma

460 (2.9)

130 (3.7)

0.24

Spontaneous bacterial peritonitis

410 (2.5)

280 (8.0)

< 0.001*

Variceal bleeding

5,585 (34.7)

1,140 (32.5)

0.28

Hepatic encephalopathy

1,145 (7.1)

520 (14.8)

< 0.001*

Procedures

Esophagogastroduodenoscopy

5,450 (33.9)

1,275 (36.3)

0.22

Blood transfusions

4,125 (25.6)

900 (25.6)

0.99

Mechanical ventilation

3,300 (20.5)

975 (27.8)

< 0.001*

Renal replacement therapy

540 (3.4)

275 (7.8)

< 0.001*

Etiology of liver disease

Alcohol-related liver disease

7,900 (49.1)

1,820 (51.9)

0.19

Hepatitis C

2,695 (16.7)

545 (15.5)

0.41

Hepatitis B

255 (1.6)

120 (3.4)

0.001*

MASLD

4,960 (30.8)

875 (24.9)

0.002*

Budd–Chiari syndrome

190 (1.2)

40 (1.1)

0.93

Cholestatic disease

495 (3.1)

125 (3.6)

0.52

Autoimmune hepatitis

285 (1.8)

85 (2.4)

0.30

Comorbidities

Congestive heart failure

1,435 (8.9)

425 (12.1)

0.006*

Cardiac arrhythmias

2,150 (13.4)

610 (17.4)

0.004*

Chronic renal failure

2,670 (16.6)

765 (21.8)

0.001*

↓ **Table 3.** Outcomes Stratified by the Presence of Sarcopenia
Outcomes	Absence of sarcopenia, n (%)	Presence of sarcopenia, n (%)	P-value	Adjusted OR	95% CI	P-value
CI: confidence interval; OR: odds ratio.
In-hospital mortality	1,245 (7.7)	415 (11.8)	< 0.001	0.95	0.67–1.36	0.789
Total complications	6,245 (38.8)	1,980 (56.4)	< 0.001	1.75	1.41–2.16	< 0.001
Gastrointestinal	585 (3.6)	360 (10.3)	< 0.001	2.5	1.83–3.43	0.038
Cardiovascular	4,385 (27.2)	1,295 (36.9)	< 0.001	1.32	1.01–1.71	< 0.001
Pulmonary	1,960 (12.2)	825 (23.5)	< 0.001	1.77	1.41–2.21	< 0.001
Renal	130 (0.8)	30 (0.9)	0.9004	1.13	0.44–2.91	0.795
Infectious	885 (5.5)	495 (14.1)	< 0.001	1.75	1.27–2.39	< 0.001
Neurologic	210 (1.3)	85 (2.4)	0.0268	1.54	0.81–2.92	0.188
Non-home discharges	4,850 (30.1)	1,875 (53.4)	< 0.001	2.2	1.77–2.73	< 0.001

↓ Table 3. Outcomes Stratified by the Presence of Sarcopenia

Outcomes

Absence of sarcopenia, n (%)

Presence of sarcopenia, n (%)

P-value

Adjusted OR

95% CI

P-value

CI: confidence interval; OR: odds ratio.

In-hospital mortality

1,245 (7.7)

415 (11.8)

< 0.001

0.95

0.67–1.36

0.789

Total complications

6,245 (38.8)

1,980 (56.4)

< 0.001

1.75

1.41–2.16

< 0.001

Gastrointestinal

585 (3.6)

360 (10.3)

< 0.001

2.5

1.83–3.43

0.038

Cardiovascular

4,385 (27.2)

1,295 (36.9)

< 0.001

1.32

1.01–1.71

< 0.001

Pulmonary

1,960 (12.2)

825 (23.5)

< 0.001

1.77

1.41–2.21

< 0.001

Renal

130 (0.8)

30 (0.9)

0.9004

1.13

0.44–2.91

0.795

Infectious

885 (5.5)

495 (14.1)

< 0.001

1.75

1.27–2.39

< 0.001

Neurologic

210 (1.3)

85 (2.4)

0.0268

1.54

0.81–2.92

0.188

Non-home discharges

4,850 (30.1)

1,875 (53.4)

< 0.001

2.2

1.77–2.73

< 0.001