Trivedi PS, et al. - Using associated International Classification of Diseases, Ninth Revision, codes in the National Inpatient Sample (n = 153,112), individuals with cirrhosis admitted with hepatorenal syndrome (HRS) between 2005 and 2014 were recognized to assess inpatient mortality following transjugular intrahepatic portosystemic shunt (TIPS) creation in comparison with medical management (MM) in patients with HRS. Comparable baseline patient demographics were noted. Higher baseline disease severity was observed in patients treated medically. Patient gender strongly altered inpatient mortality. TIPS creation presented an inpatient mortality advantage in men independent of all covariates. No mortality advantage was seen in women treated with TIPS creation. Therefore, in men, but not women admitted with HRS, TIPS creation is correlated with decreased inpatient mortality. Drivers of this gender-based disparity are currently unclear and guarantee targeted examination.