Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1301
Revised: April 21, 2024
Accepted: April 26, 2024
Published online: May 27, 2024
Processing time: 126 Days and 19.4 Hours
Transjugular intrahepatic portosystemic shunt (TIPS) is a cause of acute-on-chronic liver failure (ACLF).
To investigate the risk factors of ACLF within 1 year after TIPS in patients with cirrhosis and construct a prediction model.
In total, 379 patients with decompensated cirrhosis treated with TIPS at Nanjing Drum Tower Hospital from 2017 to 2020 were selected as the training cohort, and 123 patients from Nanfang Hospital were included in the external validation cohort. Univariate and multivariate logistic regression analyses were performed to identify independent predictors. The prediction model was established based on the Akaike information criterion. Internal and external validation were con
Age and total bilirubin (TBil) were independent risk factors for the incidence of ACLF within 1 year after TIPS. We developed a prediction model comprising age, TBil, and serum sodium, which demonstrated good discrimination and calibration in both the training cohort and the external validation cohort.
Age and TBil are independent risk factors for the incidence of ACLF within 1 year after TIPS in patients with decompensated cirrhosis. Our model showed satisfying predictive value.
Core Tip: Previous studies have proposed several models for predicting the prognosis of patients with acute-on-chronic liver failure (ACLF). However, to date, no such prediction model exists for forecasting the occurrence of ACLF following transjugular intrahepatic portosystemic shunt (TIPS). This study provides an internally and externally validated nomogram model, as well as an easy-to-use risk score scale for predicting the risk of ACLF within 1 year after TIPS. This information could enable physicians to effectively communicate the risks and benefits of the procedure to patients, facilitating shared decision-making.