Inpatient Cost Assessment of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the United States from 2001 to 2012.

Presented During:   TIPS and Portal Hypertension II
Wed, 4/6/2016: 3:27 PM  - 3:36 PM 
Vancouver Convention Centre  
Room: 220-222  

Final ID:


Submission Number:


Abstract Type:

Original Scientific Research-Oral or Poster 


A. Kuei1, E. Lee2, S. Saab2, R. Busuttil2, J. Park2, J. McWilliams2, S. Kee2


1UCLA Medical Center, San Marino, CA, 2UCLA Medical Center, Los Angeles, CA

Abstract Presenter:

Andrew Kuei  
UCLA Medical Center
San Marino, CA


Ronald W Busuttil, MD, PhD  
UCLA Medical Center
Los Angeles, CA
Stephen T. Kee, MD, MMM, FSIR  
UCLA Medical Center
Los Angeles, CA
Edward W. Lee, MD, PHD  
UCLA Medical Center
Los Angeles, CA
Justin P. McWilliams, MD  
UCLA Medical Center
Los Angeles, CA
Jonathan K. Park, MD  
UCLA Medical Center
Los Angeles, CA
Sammy Saab, MD, MPH  
UCLA Medical Center
Los Angeles, CA


Despite widespread use of transjugular intrahepatic portosystemic shunt (TIPS) as an established and proven procedure for reducing portal hypertension, a paucity of nationwide data exists on predictors of the economic impact related to TIPS. Using the National Inpatient Sample (NIS) database from 2001 to 2012, we aimed to evaluate factors contributing to hospital cost of patients admitted to U.S. hospitals for TIPS.


Using the NIS, we identified a discharge-weighted national estimate of 61,004 TIPS procedures from 2001 to 2012. Through independent sample analysis we determined profile factors related to increases in hospital costs.


Of all TIPS cases, 11.9% of patients died during hospitalization. Mean length of stay is 10.8 ± 13.1 days overall. The mean charge adjusted for inflation to the year 2012 is $125,044 ± $160,115. The mean hospital cost adjusted for inflation is $44,901 ± $54,565. Comparing pre- and post-2005, mean charges have increased considerably ($98,154 versus $142,652, p<0.001) whereas mean cost has increased slightly but significantly ($41,656 versus $46,453, p<0.001). Asian/Pacific Islander patients had the highest mean hospital cost at $62,562 ± $69,062. Patients transferred in from a different acute care hospital had an average 25.9% higher hospital cost compared to non-transfers (p<0.001). Weekend admissions incurred 18.0% higher mean hospital costs than weekday admissions (p<0.001). Hospitals in the Northeastern and Western regions had the highest mean costs ($53,598 ± $67,564 and $53,546 ± $65,556) while Southern hospitals had the lowest mean cost ($34,499 ± $35,299). Number of diagnoses and number of procedures show positive correlations with hospital cost, with number of procedures exhibiting stronger relationships (Pearson 0.613).


The cost of the TIPS procedure is gradually rising for hospitals. Alongside recent healthcare reform through the Affordable Care Act, measures to reduce the economic burden of TIPS are of increasing importance. Data from this study is intended to aid physicians and hospitals in identifying improvements that could reduce hospital costs.

Abstract Categories:

TIPS and Portal Hypertension


Cost analysis
Transjugular intrahepatic portosystemic shunt (TIPS)