78-year-old female patient was admitted to our hospital on April 20,2023,for further evaluation following the detection of elevated liver transaminases and jaundice during a routine health screening performed on April...78-year-old female patient was admitted to our hospital on April 20,2023,for further evaluation following the detection of elevated liver transaminases and jaundice during a routine health screening performed on April 18,2023.Initial biochemical assessment at the local community hospital revealed marked hepatocellular injury,with the following results:alanine aminotransferase(ALT),563.4 U/L;aspartate aminotransferase(AST),643.4 U/L.展开更多
Aim:The aim of this study is to compare the prognostic values of the Child–Pugh,integrated model for end‐stage liver disease(iMELD),albumin–bilirubin(ALBI),and Freiburg index of postsurvival(FIPS)scores in patients...Aim:The aim of this study is to compare the prognostic values of the Child–Pugh,integrated model for end‐stage liver disease(iMELD),albumin–bilirubin(ALBI),and Freiburg index of postsurvival(FIPS)scores in patients undergoing transjugular intrahepatic portosystemic shunt(TIPS).Methods:We conducted a multicenter retrospective study including patients who underwent TIPS by collecting data from several hospitals in southwest China between January 2014 and February 2021.We compared the performance of different scoring models for survival prediction in these patients.The performance of each scoring model was assessed via area under the receiver‐operating characteristic(AUROC)curve analysis.Results:The study included 378 TIPS patients(268 men,110 women;median age 52[interquartile range,45–60]years).Age;cirrhosis etiology;ascites severity;albumin levels;international normalized ratio;total bilirubin levels;sodium levels;and Child–Pugh,iMELD,ALBI,and FIPS scores were significant prognostic factors in cirrhotic patients who underwent TIPS.The Child–Pugh,iMELD,ALBI,and FIPS scores were all independent predictors of survival in TIPS patients.Survival analysis showed that all scoring models effectively stratified the prognostic risk of these patients.The Child–Pugh score was the best predictor of postoperative survival,followed by the ALBI and FIPS scores.The iMELD score was the worst predictor.The Child–Pugh,iMELD,ALBI,and FIPS scores predicted the 1‐year postoperative survival,with AUROC values of 0.832,0.677,0.761,and 0.745,respectively,and the 3‐year postoperative survival,with AUROC values of 0.710,0.668,0.721,and 0.658,respectively.The calibration curve showed that the Child–Pugh,ALBI,and FIPS models performed well in predicting 1‐and 3‐year survival,whereas the iMELD model was a poor predictor.Conclusions:The four scoring models can predict survival in cirrhotic patients after TIPS and can effectively stratify prognostic risk.The Child–Pugh score may be more suitable for predicting survival after TIPS in patients with liver cirrhosis.展开更多
基金supported by Chongqing Special Project for Technological Innovation and Application Development of Rural Revitalization(GSTB2023TIAD-ZXX0009).
文摘78-year-old female patient was admitted to our hospital on April 20,2023,for further evaluation following the detection of elevated liver transaminases and jaundice during a routine health screening performed on April 18,2023.Initial biochemical assessment at the local community hospital revealed marked hepatocellular injury,with the following results:alanine aminotransferase(ALT),563.4 U/L;aspartate aminotransferase(AST),643.4 U/L.
基金National Natural Science Foundation of China,Grant/Award Number:81802459Science and Technology Innovation Enhancement Project of Army Medical University,Grant/Award Number:2019XLC3045Chongqing Natural Science Foundation,Grant/Award Number:cstc2018jcyjAX0603。
文摘Aim:The aim of this study is to compare the prognostic values of the Child–Pugh,integrated model for end‐stage liver disease(iMELD),albumin–bilirubin(ALBI),and Freiburg index of postsurvival(FIPS)scores in patients undergoing transjugular intrahepatic portosystemic shunt(TIPS).Methods:We conducted a multicenter retrospective study including patients who underwent TIPS by collecting data from several hospitals in southwest China between January 2014 and February 2021.We compared the performance of different scoring models for survival prediction in these patients.The performance of each scoring model was assessed via area under the receiver‐operating characteristic(AUROC)curve analysis.Results:The study included 378 TIPS patients(268 men,110 women;median age 52[interquartile range,45–60]years).Age;cirrhosis etiology;ascites severity;albumin levels;international normalized ratio;total bilirubin levels;sodium levels;and Child–Pugh,iMELD,ALBI,and FIPS scores were significant prognostic factors in cirrhotic patients who underwent TIPS.The Child–Pugh,iMELD,ALBI,and FIPS scores were all independent predictors of survival in TIPS patients.Survival analysis showed that all scoring models effectively stratified the prognostic risk of these patients.The Child–Pugh score was the best predictor of postoperative survival,followed by the ALBI and FIPS scores.The iMELD score was the worst predictor.The Child–Pugh,iMELD,ALBI,and FIPS scores predicted the 1‐year postoperative survival,with AUROC values of 0.832,0.677,0.761,and 0.745,respectively,and the 3‐year postoperative survival,with AUROC values of 0.710,0.668,0.721,and 0.658,respectively.The calibration curve showed that the Child–Pugh,ALBI,and FIPS models performed well in predicting 1‐and 3‐year survival,whereas the iMELD model was a poor predictor.Conclusions:The four scoring models can predict survival in cirrhotic patients after TIPS and can effectively stratify prognostic risk.The Child–Pugh score may be more suitable for predicting survival after TIPS in patients with liver cirrhosis.
