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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9539997 | PMC |
| http://dx.doi.org/10.1111/liv.15236 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Transjugular Intrahepatic Portosystemic Shunt (TIPS) Check and Revision in a Freestanding Outpatient Facility: Safety and Efficacy.
Cureus
November 2024
Division of Interventional Radiology, Columbia University Irving Medical Center, New York, USA.
Aim This study aims to evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) check and revision procedures performed in a freestanding interventional radiology (IR) outpatient facility. Methodology A total of 40 patients (male 31:female 9, median age 60 years old) underwent a TIPS check and/or revision at a freestanding IR outpatient facility between 2009 and 2017. Procedures were performed using a mobile C-arm unit under intravenous (IV) moderate sedation, with the patient discharged home on the same day.
View Article and Find Full Text PDFActivation of the contact system and intrinsic pathway in peripheral and portal venous circulations in liver cirrhosis.
Thromb Haemost
December 2024
Dep of Cardiological, Thoracic and Vascular Sciences, University of Padua ; 2nd Chair of Internal Medicine, Padua, Italy.
Background: Portal vein system-specific risk factors contributing to portal vein thrombosis in cirrhosis are poorly investigated.
Aims: To quantify contact system and intrinsic pathway activation in peripheral compared to portal venous blood in patients with decompensated cirrhosis.
Methods: Adult patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt underwent simultaneous blood sampling from a peripheral vein and the portal vein.
Post-Transjugular Intrahepatic Portosystemic Shunt Right Atrial Pressure and Left Atrial Volume Index Predict Heart Failure and Mortality: Dual Center Experience.
Am J Gastroenterol
November 2024
Division of Gastroenterology and Hepatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Introduction: Heart failure (HF) after transjugular intrahepatic portosystemic shunt (TIPS) placement affects up to 20% of patients. Understanding factors associated with post-TIPS HF is critical. Cirrhotic cardiomyopathy (CCM) is associated with adverse clinical outcomes.
View Article and Find Full Text PDF"Bottoms-up" portal venous recanalization TIPS (PVR-TIPS) utilizing a re-entry catheter.
CVIR Endovasc
December 2024
Department of Gastroenterology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Background: Three patients with portal hypertension and gastrointestinal bleeding due to non-cirrhotic portal vein thrombosis were treated with portal venous recanalization transjugular intrahepatic portosystemic shunt (PVR-TIPS) via a trans-splenic access.
Main Body: A "bottoms-up" retrograde puncture of the right hepatic vein was performed using a re-entry catheter to gain access to the right hepatic vein. In all patients a successful retrograde puncture of the right hepatic vein was achieved, thereby restoring the splenoportal tract.
Fine-Needle Portosystemic Pressure Gradient as a Reference for Portal Hypertension in Patients with Intrahepatic Venovenous Shunt: A Prospective Study.
J Vasc Interv Radiol
December 2024
Department of Interventional Radiology, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University; Shanghai Institution of Medical Imaging, Fudan University. Electronic address:
Purpose: To evaluate the consistency and agreement between portal venous pressure measured by fine-needle (F), portal vein catheterization (D), and hepatic vein balloon-occlusion (W) in decompensated cirrhotic patients with intrahepatic venovenous shunts (IHVS).
Materials And Methods: 156 consecutive patients planning to receive transjugular intrahepatic portosystemic shunt in our center were screened for study participation. The F/D/W were assessed for consistency by Pearson coefficient (r), linear regression coefficient (R), and intraclass correlation coefficient (ICC), and for disagreement (error exceeding 20% of D) by Bland-Altman method.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!