Risk factors for portal hypertension in children with biliary atresia

Introduction: Biliary atresia is a hepatobiliary disease which frequently results in portal hypertension.
Objectives: To analyse the risk factors for portal hypertension in children with biliary atresia.
Method: A case-controlled study was performed on 96 children with biliary atresia. Subjects were enrolled based on the inclusion and exclusion criteria. Medical history, physical examination results, imaging data, and laboratory examination results were collected prospectively. Patients were divided into two groups based on the signs of portal hypertension clinically during the follow-up period. Risk factors for portal hypertension were analysed using SPSS. Univariate analysis was used first to identify possible risk factors. A multivariate analysis was performed using logistic regression with p significant <0.05.
Results: The median age was 18.21 (3.14-128.86) weeks in the portal hypertension group and 9.07 (1.00-50.57) weeks in the non-portal hypertension group. Age, duration of illness, birth weight, gestational age, and laboratory examination [Haemoglobin (Hb), white blood cell (WBC) count, albumin, direct bilirubin, total bilirubin, prothrombin time (PT), gamma-glutamyl transferase (GGT), aspartate transaminase (AST), and AST: alanine transaminase (ALT) ratio] were significantly different in the 2 groups (p<0.05). For every one-week increase in the subject's age, the risk of portal hypertension increased by 1.127. For every one unit increase in Hb, PT, GGT, and the AST:ALT ratio, the risk of having portal hypertension was 0.746, 1.125, 1.00, and 2.862 in children with biliary atresia (p<0,05).
Conclusions: The risk factors for portal hypertension in children with biliary atresia were age, Hb, PT, GGT levels, and the AST:ALT ratio.