Bayesian network-based survival prediction model for patients having undergone post-transjugular intrahepatic portosystemic shunt for portal hypertension

doi:10.3748/wjg.v30.i13.1859

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Gastroenterol. Apr 7, 2024; 30(13): 1859-1870
Published online Apr 7, 2024. doi: 10.3748/wjg.v30.i13.1859

Table 1 Baseline characteristics of the study cohort, n (%)

Variable		Variable
Sex		None	151 (38.4)
Male	278 (70.7)	Small	138 (35.1)
Female	115 (29.3)	Moderate to large	104 (26.5)
Age (yr)		Pre-HE
< 60	307 (78.1)	No	387 (98.5)
≥ 60	86 (21.9)	Yes	6 (1.5)
Etiology of cirrhosis		SBP
Hepatitis B virus	254 (64.6)	Yes	106 (27.0)
Hepatitis C virus	16 (4.1)	No	287 (73.0)
Alcoholic	35 (8.9)	Type of stent
Autoimmune	40 (10.2)	Composite stent¹	265 (67.2)
Others	48 (12.2)	Viatorr^® stent	128 (32.6)
Diabetes		Pre-PVP (mmH₂O)
Yes	67 (17.0)	> 33.9	305 (77.6)
No	326 (83.0)	≤ 33.9	88 (22.4)
Hypertension		Post-PVP (mmH₂O)
Yes	27 (6.9)	> 23.1	295 (75.1)
No	366 (93.1)	≤ 23.1	98 (24.9)
Indications for TIPS		K (mmol/L)
Variceal bleeding	357 (90.8)	< 3.5	95 (24.2)
Refractory ascites	36 (9.2)	3.5-5.5	295 (75.1)
Formation of PVT		> 5.3	3 (0.8)
Yes	94 (23.9)	Na (mmol/L)
No	299 (76.1)	< 137	124 (31.6)
Endoscopic treatment history		≥ 137	269 (68.4)
Yes	115 (29.3)	BUN (mmol/L)
No	278 (70.7)	< 3.1	28 (7.1)
Splenectomy history		≥ 3.1	365 (92.9)
Yes	15 (3.8)	SCr (μmol/L)
No	378 (96.2)	≤ 106	356 (90.6)
Ascites		> 106	37 (9.4)
ALB (g/L)		PT (s)
< 40	330 (84.0)	≤ 14.5	54 (13.7)
≥ 40	63 (16.0)	> 14.5	339 (86.3)
ALT (U/L)	352 (88.0)	FIB (g/L)
≤ 50	350 (89.1)	< 2	216 (55.0)
> 50	43 (10.9)	≥ 2	177 (45.0)
AST (U/L)		Hb (g/L)
≤ 40	279 (71.0)	< 130	328 (83.5)
> 40	114 (29.0)	≥ 130	65 (16.5)
ALP (U/L)		WBC (10⁹/L)
≤ 135	342 (87.0)	< 3.5	236 (60.1)
> 135	51 (13)	3.5-9.5	144 (36.6)
GGT (U/L)		> 9.5	13 (3.3)
≤ 60	295 (75.1)	PLT (10⁹/L)
> 60	98 (24.9)	< 125	322 (81.9)
TBIL (μmol/L)		≥ 125	71 (18.1)
≤ 28	301 (76.6)	Child-Pugh grade
> 28	92 (23.4)	A	169 (43.0)
PA (mg/L)		B	185 (47.1)
< 150	321 (81.7)	C	39 (9.9)
≥ 150	72 (18.3)	MELD score
INR		Low risk	354 (90.1)
≤ 1.3	190 (48.3)	Medium risk	31 (7.9)
> 1.3	203 (51.7)	High risk	8 (2.0)

¹Combined stent: Covered stent + bare stent.

TIPS: Transjugular intrahepatic portosystemic shunt; PVT: Portal vein thrombosis; pre-HE: Preoperative hepatic encephalopathy; SBP: Spontaneous bacterial peritonitis; pre-PVP: Preoperative portal vein pressures; post-PVP: Postoperative portal vein pressures; K: Potassium; Na: Sodium; SCr: Serum creatinine; BUN: Blood urea nitrogen; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase; TBIL: Total bilirubin; PA: Prealbumin; INR: International normalized ratio; PT: Prothrombin time; FIB: Fibrinogen; Hb: Hemoglobin; WBC: White blood cell count; PLT: Platelets; MELD: Model for end-stage liver disease.

Table 2 Univariate survival analysis of patients having undergone transjugular intrahepatic portosystemic shunt surgery for portal hypertension

Variable	HR	95%CI	P value	Variable	HR	95%CI	P value
Age (yr)				< 40	1.00
< 60	1.00			≥ 40	0.39	0.16-0.97	0.043
≥ 60	3.64	2.24-5.89	< 0.001	AST (U/L)
Etiology of cirrhosis				≤ 40	1.00
Hepatitis B virus	1.00			> 40	1.73	1.07-2.81	0.026
Hepatitis C virus	0.85	0.20-3.53	0.820	ALP (U/L)
Alcoholic	3.23	1.74-5.99	< 0.001	≤ 135	1.00
Autoimmune	1.51	0.67-3.41	0.317	> 135	2.60	1.5-4.51	< 0.001
Others	1.34	0.64-2.78	0.434	TBIL (µmol/L)
Hypertension				≤ 28	1.00
No	1.00			> 28	2.65	1.64-4.29	< 0.001
Yes	3.75	1.89-7.44	< 0.001	PA (mg/L)
Indications for TIPS				< 150	1.00
Variceal bleeding	1.00			≥ 150	0.38	0.16-0.88	0.024
Refractory ascites	2.23	1.14-4.36	0.020	WBC (10⁹/L)
Ascites				< 3.5	1.00
None	1.00			3.5-9.5	1.70	1.04-2.76	0.033
Small	0.61	0.31-1.22	0.164	> 9.5	1.49	0.46-4.88	0.507
Moderate to large	2.51	1.48-4.26	< 0.001	Child-Pugh grade
Post-TIPS PVP (mmH₂O)				A	1.00
≤ 23.1	1.00			B	2.09	1.16-3.76	0.014
> 23.1	2.85	1.30-6.23	0.009	C	5.12	2.53-10.37	< 0.001
Na (mmol/L)				MELD score
< 137	1.00			Low risk	1.00
≥ 137	0.54	0.33-0.89	0.016	Medium risk	2.33	1.18-4.58	0.014
ALB (g/L)				High risk	5.98	2.38-15.05	< 0.001

Post-PVP: Postoperative portal vein pressures; Na: Sodium; ALB: Albumin; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; TBIL: Total bilirubin; PA: Prealbumin; WBC: White blood cell count; MELD: Model for end-stage liver disease.

Citation: Chen R, Luo L, Zhang YZ, Liu Z, Liu AL, Zhang YW. Bayesian network-based survival prediction model for patients having undergone post-transjugular intrahepatic portosystemic shunt for portal hypertension. World J Gastroenterol 2024; 30(13): 1859-1870
URL: https://www.wjgnet.com/1007-9327/full/v30/i13/1859.htm
DOI: https://dx.doi.org/10.3748/wjg.v30.i13.1859