Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Fürschuß, L; Rainer, F; Effenberger, M; Niederreiter, M; Portugaller, RH; Horvath, A; Fickert, P; Stadlbauer, V.
A novel score predicts mortality after transjugular intrahepatic portosystemic shunt: MOTS - Modified TIPS Score.
Liver Int. 2022; 42(8):1849-1860
Doi: 10.1111/liv.15236
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Rainer Florian
- Co-Autor*innen der Med Uni Graz
- Fickert Peter
- Horvath Angela
- Portugaller Rupert
- Smolle Luisa Sophie
- Stadlbauer-Köllner Vanessa
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- 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.
- Find related publications in this database (using NLM MeSH Indexing)
- Ascites - complications
- Bilirubin - administration & dosage
- Hepatic Encephalopathy - complications
- Humans - administration & dosage
- Liver Cirrhosis - complications
- Portasystemic Shunt, Transjugular Intrahepatic - administration & dosage
- Retrospective Studies - administration & dosage
- Treatment Outcome - administration & dosage
- Urea - administration & dosage
- Find related publications in this database (Keywords)
- hepatic encephalopathy
- mortality
- prediction
- renal insufficiency
- risk
- transjugular intrahepatic portosystemic shunt