Comparison of survival prediction values of different scoring models for patients undergoing transjugular intrahepatic portal shunt: A multicenter retrospective study

Abstract

AbstractAimThe aim of this study is to compare the prognostic values of the Child–Pugh, integrated model for end‐stage liver disease (iMELD), albumin–bilirubin (ALBI), and Freiburg index of postsurvival (FIPS) scores in patients undergoing transjugular intrahepatic portosystemic shunt (TIPS).MethodsWe conducted a multicenter retrospective study including patients who underwent TIPS by collecting data from several hospitals in southwest China between January 2014 and February 2021. We compared the performance of different scoring models for survival prediction in these patients. The performance of each scoring model was assessed via area under the receiver‐operating characteristic (AUROC) curve analysis.ResultsThe study included 378 TIPS patients (268 men, 110 women; median age 52 [interquartile range, 45–60] years). Age; cirrhosis etiology; ascites severity; albumin levels; international normalized ratio; total bilirubin levels; sodium levels; and Child–Pugh, iMELD, ALBI, and FIPS scores were significant prognostic factors in cirrhotic patients who underwent TIPS. The Child–Pugh, iMELD, ALBI, and FIPS scores were all independent predictors of survival in TIPS patients. Survival analysis showed that all scoring models effectively stratified the prognostic risk of these patients. The Child–Pugh score was the best predictor of postoperative survival, followed by the ALBI and FIPS scores. The iMELD score was the worst predictor. The Child–Pugh, iMELD, ALBI, and FIPS scores predicted the 1‐year postoperative survival, with AUROC values of 0.832, 0.677, 0.761, and 0.745, respectively, and the 3‐year postoperative survival, with AUROC values of 0.710, 0.668, 0.721, and 0.658, respectively. The calibration curve showed that the Child–Pugh, ALBI, and FIPS models performed well in predicting 1‐ and 3‐year survival, whereas the iMELD model was a poor predictor.ConclusionsThe four scoring models can predict survival in cirrhotic patients after TIPS and can effectively stratify prognostic risk. The Child–Pugh score may be more suitable for predicting survival after TIPS in patients with liver cirrhosis.