Comparing efficacy of different scoring models to predict hepatic encephalopathy after TIPS in cirrhotic patients.

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Annals of medicine Pub Date : 2025-12-01 Epub Date: 2025-06-06 DOI:10.1080/07853890.2025.2514082

Xin-Jian Xu, Liang Yin, Yi-Jiang Zhu, Dong Lu, Xiang-Zhong Huang, Wei-Fu Lv, Chun-Ze Zhou, De-Lei Cheng

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Abstract

Background: Assessing hepatic encephalopathy (HE) risk post-transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients is crucial. This study compares the predictive performance of Child-Pugh and Model for End-Stage Liver Disease (MELD), CLIFC-AD and Freiburg index of post-TIPS survival (FIPS) scores for overt and severe HE. To compare the predictive value of Child-Pugh, MELD, CLIFC-AD and FIPS scores for overt and severe HE post-TIPS in cirrhotic patients.

Materials and methods: We retrospectively analysed data from 406 cirrhotic TIPS patients (January 2017-January 2021). Scoring models were assessed for differentiation (C-index), calibration, clinical utility and overall performance at 1, 3, 6 and 12 months post-TIPS.

Results: Predictive performance for overt HE post-TIPS was low across models. FIPS had superior predictive ability for severe HE at 1 and 12 months post-TIPS (C-index: 0.781, 0.705). FIPS and CLIFC-AD showed good predictive capacity for severe HE in sarcopenic patients at 1 and 12 months (FIPS: C-index 0.863, 0.757; CLIFC-AD: C-index 0.748, 0.732). FIPS had the highest hazard ratio for severe HE (HR = 3.520, 95% CI: 2.134-5.807) and CLIFC-AD for overt HE (HR = 2.132, 95% CI: 1.581-2.874).

Conclusion: FIPS and CLIFC-AD scores demonstrate significant predictive ability for severe HE post-TIPS, particularly in sarcopenic patients.

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比较不同评分模型预测肝硬化患者TIPS术后肝性脑病的疗效。

背景：评估肝硬化患者经颈静脉肝内门体分流术（TIPS）后肝性脑病（HE）的风险至关重要。本研究比较了Child-Pugh和终末期肝病模型（MELD）、cclic - ad和tips后生存指数（FIPS）评分对明显和严重HE的预测性能。比较Child-Pugh、MELD、cclic - ad和FIPS评分对肝硬化患者tips后明显和严重HE的预测价值。材料和方法：我们回顾性分析了406例肝硬化TIPS患者（2017年1月- 2021年1月）的数据。在tips后1、3、6和12个月评估评分模型的分化（c指数）、校准、临床效用和整体表现。结果：在所有模型中，显性HE后提示的预测性能都很低。FIPS对tips后1个月和12个月重度HE的预测能力较好（C-index: 0.781, 0.705）。FIPS和cclic - ad对肌肉减少症患者1个月和12个月的严重HE有较好的预测能力(FIPS: C-index 0.863, 0.757；cclic - ad: C-index 0.748, 0.732)。FIPS对严重HE的风险比最高（HR = 3.520, 95% CI: 2.134-5.807），而cclic - ad对明显HE的风险比最高（HR = 2.132, 95% CI: 1.581-2.874）。结论：FIPS和cclic - ad评分对tips后严重HE有显著的预测能力，尤其是对肌肉减少症患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Annals of medicine

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