Abstract: Objective The purpose of this study was to investigate prevalence of and risk factors for overt hepatic encephalopathy (OHE) in patients with liver cirrhosis (LC) with portal hypertension (PH) after transjugular intrahepatic portosystemic shunt (TIPS) placement. Methods A total of 118 patients with hepatitis B-induced LC and PH were encountered in our hospital between October 2023 and June 2025, and all underwent TIPS placement routinely. Multivariate Logistic regression analysis was applied to find risk factors for occurrence of OHE. Results The prevalence of OHE was 22.9% after TIPS in our series;percentages of HE history, Child-Pugh class C and sarcopenia in patients with OHE were 25.9%, 81.5% and 66.7%, all significantly higher than 8.8%, 22.0% and 16.5%, and MELD score, INR, blood ammonia and diameter of stents were 16(12,19)points, (1.3±0.2), (78.5±22.6)μmol/L and (10.4±1.2)mm,all significantly higher or greater than [12(10,15)points,(1.2±0.2), (32.9±9.4)μmol/L and (8.9±1.1)mm,P<0.05] in those without OHE, Δportal pressure gradient (ΔPPG) was(10.3±3.6)mmHg, much greater than [(7.5±3.2)mmHg, P<0.05] in those without OHE; multivariate Logistic regression analysis showed that HE history (OR=3.25,P=0.041), Child-Pugh clas C(OR=2.62,P=0.033), MELD score (OR=1.12,P=0.018), serum albumin level (OR=0.92,P=0.031), blood ammonia level (OR=1.28,P=0.004), concomitant sarcopenia (OR=2.15,P=0.048), stent diameter (OR=2.80,P=0.023) and ΔPPG(OR=3.10,P=0.009) were all the independent risk factors for OHE occurrence. Conclusion The occurrence of OHE after TIPS in patients with HBV-induced LC is very common, and appropriate prevention and management might improve patients’quality of life.

Key words: Liver cirrhosis, Portal hypertension, Transjugular intrahepatic portosystemic shunt, Overt hepatic encephalopathy, Risk factors