Validation of prognostic indices in Egyptian Budd-Chiari syndrome patients: A single-center study

Table 1 Factors related to the one-year survival

	Alive (n = 135)	Dead (n = 59)	χ2/t	P value
	n (%)	n (%)
Age in years, mean ± SD	28.6 ± 8.47	29.22 ± 10.01	0.44	0.66
Gender
Male	53 (39.3)	30 (50.8)	2.25	0.13
Female	82 (60.7)	29 (49.2)
Genital/oral ulcer	2 (1.5)	6 (10.2)	7.84	0.01
History of DVT	13 (9.6)	17 (28.8)	11.56	0.001
Use of OCP1	15 (18.3)	11 (37.9)	5.25	0.02
Presentation
Acute/subacute	31 (23)	28 (47.5)	11.64	0.001
Chronic	104 (77)	31 (52.5)
Jaundice	45 (33.3)	40 (67.8)	19.81	< 0.001
Hepatic encephalopathy	14 (10.4)	24 (40.7)	23.94	< 0.001
Ascites	110 (81.5)	56 (94.9)	6.00	0.01
Ascites score2
1	26 (19.3)	3 (5.1)	51.38	< 0.001
2	89 (65.9)	17 (28.8)
3	20 (14.8)	39 (66.1)
IVC (occluded/attenuated/web)	16 (11.9)	16 (27.1)	6.95	0.01
PV thrombosis	1 (0.7)	7 (11.9)	12.85	< 0.001
Total bilirubin, mean ± SD	2.15 ± 1.40	5.05 ± 4.93	4.44	< 0.001
Direct bilirubin, mean ± SD	0.90 ± 0.80	2.59 ± 2.94	4.34	< 0.001
Albumin, mean ± SD	3.46 ± 0.63	2.89 ± 0.65	5.75	< 0.001

¹Percentage was calculated among female patients;

²Ascites score was calculated as (1): absent, (2): controlled with sodium restriction or diuretics, or (3): resistant to medical treatment. DVT: Deep venous thrombosis; OCP: Oral contraceptive pills; IVC: Inferior vena cava; PV: Portal vein.

Table 2 Relation between different prognostic indices and the one-year survival rate

	One-year survival		t	P value
	Alive (n = 135)	Dead (n = 59)
	mean ± SD	mean ± SD
Child score	7.54 ± 1.79	10.17 ± 2.28	7.85	< 0.001
MELD score	10.42 ± 5.44	16.42 ± 8.40	5.05	< 0.001
Clichy PI	4.64 ± 0.94	5.89 ± 1.09	8.12	< 0.001
New clichy PI	3.24 ± 1.18	4.82 ± 1.37	8.11	< 0.001
Rotterdam index	1.78 ± 0.88	3.41 ± 2.15	5.64	< 0.001
BCS-TIPS score1	3.61 ± 0.83	4.33 ± 0.97	2.99	0.003

¹Calculated only for 107 patients who underwent TIPS. MELD: Model for end-stage liver disease; PI: Prognostic index; BCS-TIPS score: Budd-Chiari syndrome-transjugular intrahepatic portosystemic shunt score.

Table 3 Diagnostic performance of prognostic indices for prediction of one-year survival among the studied patients

Prognostic indices	Cut-off	Sensitivity	Specificity	AUC	SE	P value	95%CI
Child score	≥ 8.55	72.90%	72.60%	0.811	0.034	< 0.001	0.743-0.878
MELD score	≥ 11.59	69.50%	64.40%	0.723	0.042	< 0.001	0.641-0.805
Clichy PI	≥ 4.95	78.00%	70.40%	0.807	0.036	< 0.001	0.735-0.878
New clichy PI	≥ 3.75	78.00%	73.30%	0.806	0.036	< 0.001	0.735-0.878
Rotterdam index	≥ 1.94	71.20%	65.20%	0.771	0.038	< 0.001	0.696-0.845
BCS-TIPS score1	≥ 3.92	71.40%	64.50%	0.715	0.072	0.010	0.574-0.857

¹Calculated only for 107 patients who underwent TIPS. AUC: Area under the receiver operating characteristic (ROC) curve; MELD: Model for end-stage liver disease; PI: Prognostic index; BCS-TIPS score: Budd-Chiari syndrome-transjugular intrahepatic portosystemic shunt score; SE: Standard error.

Table 4 Logistic regression analysis for factors affecting the one-year survival

	B	P value	OR (95%CI)
New Clichy PI	0.291	0.030	1.338 (1.029-1.741)
Hepatic encephalopathy	0.731	0.118	2.077 (0.830-5.199)
Total bilirubin	0.194	0.047	1.214 (1.003-1.470)
Albumin	-0.857	< 0.001	0.424 (0.323-0.558)

B: Regression coefficient; PI: Prognostic index.

Table 5 Relation between different prognostic indices and the one-year shunt patency in transjugular intrahepatic portosystemic shunt patients

	One-year shunt patency1		t	P value
	Patent (n = 77)	Occluded (n =19)
	mean ± SD	mean ± SD
Child score	7.67 ± 1.69	7.74 ± 2.00	0.15	0.89
MELD score	10.26 ± 5.32	10.56 ± 7.17	0.21	0.84
Clichy PI	4.70 ± 0.92	4.86 ± 1.06	0.65	0.52
New Clichy PI	3.32 ± 1.16	3.52 ± 1.34	0.65	0.52
Rotterdam index	1.79 ± 0.80	1.99 ± 1.05	0.91	0.37
BCS-TIPS score	3.57 ± 0.80	3.73 ± 1.03	0.69	0.49

¹Total transjugular intrahepatic portosystemic shunt (TIPS) patients was 107, among them eleven patients died and 96 patients completed the one-year follow up. MELD: Model for end-stage liver disease; PI: Prognostic index; BCS-TIPS score: Budd-Chiari syndrome-transjugular intrahepatic portosystemic shunt score.