1. Long-term survival prediction for transjugular intrahepatic portosystemic shunt in severe cirrhotic ascites: assessment of ten prognostic models
- Author
-
Yong Lv, Daiming Fan, Zhanxin Yin, Hui Xue, Xuan Zhu, Enxin Wang, Jing Li, Zhexuan Wang, Shihao Tang, Jianbo Zhao, Jielai Xia, Shuai Guo, Jing Niu, Qiao-Yi Yang, Jun-Hui Sun, Zhengyu Wang, Xiaoli Zhu, Zai-bo Jiang, Qiuhe Wang, Guohong Han, Chunqing Zhang, and Weixin Ren
- Subjects
Liver Cirrhosis ,Poor prognosis ,medicine.medical_specialty ,medicine.medical_treatment ,Severity of Illness Index ,Gastroenterology ,End Stage Liver Disease ,Liver disease ,Internal medicine ,Ascites ,Long term survival ,Humans ,Medicine ,In patient ,Prognostic models ,Retrospective Studies ,Hepatology ,business.industry ,Prognosis ,medicine.disease ,Treatment Outcome ,Cohort ,Portasystemic Shunt, Transjugular Intrahepatic ,medicine.symptom ,business ,Transjugular intrahepatic portosystemic shunt - Abstract
OBJECTIVES Patients with severe cirrhotic ascites have poor prognosis, yet individual patient survival varies greatly. Therefore, suitable prognostic models can be helpful in clinical decision making. The aim of this study was to evaluate and compare the performance of 10 scores in predicting transplant-free survival (TFS) after transjugular intrahepatic portosystemic shunt (TIPS) in severe cirrhotic ascites. METHODS Two hundred eighty consecutive cirrhotic patients with severe ascites undergoing TIPS between March 2006 and December 2017 were retrospectively screened and included from nine tertiary Chinese centers, consisting of 123 patients with refractory ascites and 157 with recurrent ascites. Discriminatory ability of these models was further assessed in the whole cohort and subgroups. RESULTS TFS rates of all 280 patients were 75.4, 65.7, and 53.6% at 6-month, 1-year, and 2-year follow-up, respectively. Compared with other prognostic systems, the integrated model for end-stage liver disease (iMELD, incorporating serum sodium and age) showed optimal performance in predicting 6-month, 1-year, and 2-year TFS. Cutoffs were determined according to c-index and were used to stratify patients into three strata presenting significantly different TFS for short-term and long-term: iMELD
- Published
- 2020