A novel score predicts mortality after transjugular intrahepatic portosystemic shunt : MOTS - Modified TIPS Score
© 2022 The Authors. Liver International published by John Wiley & Sons Ltd..
BACKGROUND AND AIMS: The high risk for severe shunting-related post-interventional complications demands a stringent selection of candidates for transjugular intrahepatic portosystemic shunt (TIPS). We aimed to develop a simple and reliable tool to accurately predict early post-TIPS mortality.
METHODS: 144 cases of TIPS implantation were retrospectively analysed. Using univariate and multivariate Cox regression analysis of factors predicting mortality within 90 days after TIPS, a score integrating urea, international normalized ratio (INR) and bilirubin was developed. The Modified TIPS-Score (MOTS) ranges from 0 to 3 points: INR >1.6, urea >71 mg/dl and bilirubin >2.2 mg/dl account for one point each. Additionally, MOTS was tested in an external validation cohort (n = 187) and its performance was compared to existing models.
RESULTS: Modified TIPS-Score achieved a significant prognostic discrimination reflected by 90-day mortality of 8% in patients with MOTS 0-1 and 60% in patients with MOTS 2-3 (p < .001). Predictive performance (area under the curve) of MOTS was accurate (c = 0.845 [0.73-0.96], p < .001), also in patients with renal insufficiency (c = 0.830 [0.64-1.00], p = .02) and in patients with refractory ascites (c = 0.949 [0.88-1.00], p < .001), which are subgroups with particular room for improvement of post-TIPS mortality prediction. The results were reproducible in the validation cohort.
CONCLUSIONS: Modified TIPS-Score is a novel, practicable tool to predict post-TIPS mortality, that can significantly simplify clinical decision making. Its practical applicability should be further investigated.
| Errataetall: |
CommentIn: Liver Int. 2022 Jul;42(7):1700-1701. - PMID 35593018 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Liver international : official journal of the International Association for the Study of the Liver - 42(2022), 8 vom: 02. Aug., Seite 1849-1860 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fürschuß, Luisa [VerfasserIn] |
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| Links: |
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| Themen: |
8W8T17847W |
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| Anmerkungen: |
Date Completed 25.07.2022 Date Revised 14.02.2024 published: Print-Electronic ClinicalTrials.gov: NCT03459378 CommentIn: Liver Int. 2022 Jul;42(7):1700-1701. - PMID 35593018 Citation Status MEDLINE |
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| doi: |
10.1111/liv.15236 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM337920443 |
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| 245 | 1 | 2 | |a A novel score predicts mortality after transjugular intrahepatic portosystemic shunt |b MOTS - Modified TIPS Score |
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| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03459378 | ||
| 500 | |a CommentIn: Liver Int. 2022 Jul;42(7):1700-1701. - PMID 35593018 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. Liver International published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND AND AIMS: The high risk for severe shunting-related post-interventional complications demands a stringent selection of candidates for transjugular intrahepatic portosystemic shunt (TIPS). We aimed to develop a simple and reliable tool to accurately predict early post-TIPS mortality | ||
| 520 | |a METHODS: 144 cases of TIPS implantation were retrospectively analysed. Using univariate and multivariate Cox regression analysis of factors predicting mortality within 90 days after TIPS, a score integrating urea, international normalized ratio (INR) and bilirubin was developed. The Modified TIPS-Score (MOTS) ranges from 0 to 3 points: INR >1.6, urea >71 mg/dl and bilirubin >2.2 mg/dl account for one point each. Additionally, MOTS was tested in an external validation cohort (n = 187) and its performance was compared to existing models | ||
| 520 | |a RESULTS: Modified TIPS-Score achieved a significant prognostic discrimination reflected by 90-day mortality of 8% in patients with MOTS 0-1 and 60% in patients with MOTS 2-3 (p < .001). Predictive performance (area under the curve) of MOTS was accurate (c = 0.845 [0.73-0.96], p < .001), also in patients with renal insufficiency (c = 0.830 [0.64-1.00], p = .02) and in patients with refractory ascites (c = 0.949 [0.88-1.00], p < .001), which are subgroups with particular room for improvement of post-TIPS mortality prediction. The results were reproducible in the validation cohort | ||
| 520 | |a CONCLUSIONS: Modified TIPS-Score is a novel, practicable tool to predict post-TIPS mortality, that can significantly simplify clinical decision making. Its practical applicability should be further investigated | ||
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