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Preoperative prediction of overt hepatic encephalopathy caused by transjugular intrahepatic portosystemic shunt

Authors :
Yang, Yang
Xueqing, Liang
Shirui, Yang
Xiaofeng, He
Mingsheng, Huang
Wenfeng, Shi
Junyang, Luo
Chongyang, Duan
Xinghui, Feng
Sirui, Fu
Ligong, Lu
Source :
European Journal of Radiology. 154:110384
Publication Year :
2022
Publisher :
Elsevier BV, 2022.

Abstract

Preoperative prediction of overt hepatic encephalopathy (OHE) should be performed in patients with variceal bleeding treated using the transjugular intrahepatic portosystemic shunt (TIPS) procedure. A reliable prediction tool is therefore required.Patients with cirrhosis-related variceal bleeding treated using the TIPS procedure were screened at two hospitals. Patients classified as Child-Pugh Class B were identified. The least absolute shrinkage and selection operator method and the backward stepwise selection method were used to screen the clinical and radiological characteristics of participants. Then, models were constructed accordingly to predict OHE. Area under the receiver operating characteristic curves, calibration curves, and decision curves were performed to discover the optimal model. Finally, whether clinical factors influenced the performance of our optimal model was tested.A total of 191 patients were included (training cohort: 127 cases; validation cohort: 64 cases). Three novel radiological independent risk factors were found. The combined model outperformed the models containing clinical factors or radiological characteristics alone. The areas under the curve for the training and validation cohorts were 0.901 and 0.903, respectively, with satisfactory calibration and decision curves. The Model for End-Stage Liver Disease score, serum sodium, albumin, total bilirubin, and age exhibited limited influence on the performance of the combined model.These radiological characteristics are also independent risk factors for post-TIPS OHE. Combining clinical factors and radiological characteristics was an effective means of predicting OHE. This study's model could be used for preoperative selection of appropriate patients before the TIPS procedure is performed.

Details

ISSN :
0720048X
Volume :
154
Database :
OpenAIRE
Journal :
European Journal of Radiology
Accession number :
edsair.doi.dedup.....2c1206ec1da43473387eb65d04e54aa7
Full Text :
https://doi.org/10.1016/j.ejrad.2022.110384