{"title":"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。","authors":"Xin-Jian Xu, Liang Yin, Yi-Jiang Zhu, Dong Lu, Xiang-Zhong Huang, Wei-Fu Lv, Chun-Ze Zhou, De-Lei Cheng","doi":"10.1080/07853890.2025.2514082","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>FIPS and CLIFC-AD scores demonstrate significant predictive ability for severe HE post-TIPS, particularly in sarcopenic patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2514082"},"PeriodicalIF":4.3000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147511/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparing efficacy of different scoring models to predict hepatic encephalopathy after TIPS in cirrhotic patients.\",\"authors\":\"Xin-Jian Xu, Liang Yin, Yi-Jiang Zhu, Dong Lu, Xiang-Zhong Huang, Wei-Fu Lv, Chun-Ze Zhou, De-Lei Cheng\",\"doi\":\"10.1080/07853890.2025.2514082\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>FIPS and CLIFC-AD scores demonstrate significant predictive ability for severe HE post-TIPS, particularly in sarcopenic patients.</p>\",\"PeriodicalId\":93874,\"journal\":{\"name\":\"Annals of medicine\",\"volume\":\"57 1\",\"pages\":\"2514082\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147511/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/07853890.2025.2514082\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/07853890.2025.2514082","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/6 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Comparing efficacy of different scoring models to predict hepatic encephalopathy after TIPS in cirrhotic patients.
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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