Initial studies identified advanced age as an independent predictor of early mortality after TIPS, attributing it to age-related physiologic decline in hepatic functional reserve, which might not be picked up on routine laboratory tests[166,167].
最初的研究确定，高龄是TIPS后早期死亡率的独立预测因子，将其归因于与年龄相关的肝功能储备生理下降，这可能在常规实验室检测[166,167]中没有发现。
However, the majority of patients in these studies received bare-metal stents for TIPS.
然而，这些研究中的大多数患者接受了裸金属支架治疗TIPS。
Also, there was significant heterogeneity in terms of severity of underlying disease in the study group with different cut-offs for defining advanced age, precluding drawing of any robust conclusions.
此外，在定义晚期的基础疾病严重程度的研究组中存在显著的异质性，排除了得出任何稳健的结论。
Nevertheless, a recent study using covered stents for TIPS did find a trend towards greater mortality and hospitalization in the elderly, without reaching statistical significance[168].
然而，最近一项使用覆膜支架治疗TIPS的研究确实发现了老年人死亡率和住院率上升的趋势，但没有达到具有统计学意义的[168]。
Another retrospective study in which the subjects were well matched for MELD score, indication for TIPS, and comorbidities showed that age is strongly and independently associated with 90-day post-TIPS mortality risk, particularly in those > 70 years[169].
在另一项回顾性研究中，受试者的MELD评分、TIPS适应症和合并症匹配表明，年龄与TIPS后90天死亡风险密切独立相关，特别是在70岁[169]中。
Adlakha et al[170], in a retrospective study of 100 patients, similarly showed that re-admission rates and incidence of severe HE requiring hospital admission were higher in elderly patients, even after accounting for MELD score.
Adlakha[170]等人，在一项对100名患者的回顾性研究中，同样表明，即使考虑到MELD评分，老年患者再次入院率和需要严重HE住院的发生率也更高。
They also found that TIPS for secondary prophylaxis of variceal bleeding, RA, and HH had acceptable morbidity and mortality.
他们还发现，用于二次预防静脉曲张出血、RA和HH的TIPS具有可接受的发病率和死亡率。
However, there was high mortality when TIPS was placed for acute variceal bleed, even in patients with MELD score < 18.
然而，当TIPS治疗急性静脉曲张出血时，死亡率很高，即使是MELD评分＜18的患者，死亡率也很高。
There was a trend towards increased 30 d mortality despite a low baseline MELD, particularly in patients aged 80 years and more, without reaching statistical significance.
尽管基线MELD较低，但30天死亡率有增加的趋势，特别是在80岁及以上的患者中，没有达到统计学意义。
Current evidence suggests that older age (no absolute cut-off; generally accepted as > 65 years) is a relevant consideration in assessing mortality risk of TIPS.
目前的证据表明，年龄较大(无绝对临界值；一般接受为65岁）是评估TIPS死亡风险的相关考虑因素。
However, advanced age alone should not be an absolute contraindication for TIPS, especially for conditions in which TIPS has proven benefit in terms of symptomatic relief and survival, like acute variceal bleeding or RA.
然而，高龄本身不应该是TIPS的绝对禁忌症，特别是对于TIPS已被证明在症状缓解和生存方面有益处的情况，如急性静脉曲张出血或RA。
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