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A modified model for predicting mortality after transjugular intrahepatic portosystemic shunt: A multicentre study
Yujie Zhao1,2, Yang Yang1, Weifu Lv3
1Zhuhai Interventional Medical Center, Zhuhai Hospital Affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China.
Summary
A new model predicts mortality after transjugular intrahepatic portosystemic shunt (TIPS) procedures. This tool helps clinicians select patients for TIPS, improving outcomes and decision-making for this controversial procedure.
Area of Science:
- Hepatology and Interventional Radiology
- Clinical Decision Support Systems
- Predictive Modeling in Medicine
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) placement has debated survival benefits, necessitating careful preoperative patient selection.
- Accurate prediction of post-TIPS mortality is crucial for optimizing clinical decision-making and patient management.
Purpose of the Study:
- To develop and validate a novel predictive model for post-TIPS mortality.
- To enhance clinical decision-making regarding patient eligibility for TIPS procedures.
Main Methods:
- A modified prediction model for post-TIPS mortality (ModelMT) was developed using logistic regression on data from 811 patients across five hospitals.
- ModelMT was trained and externally validated, with its performance compared against seven existing models (ALBI, BILI-PLT, MELD-Na, MOTS, FIPS, MELD, CLIF-C AD).
- Discrimination, calibration, and risk stratification into low, medium, high, and extremely high-risk groups were assessed.
Main Results:
- ModelMT demonstrated strong predictive efficiency with an AUC of 0.875 (training) and 0.852 (validation).
- ModelMT significantly outperformed previous models in discrimination and calibration (p < .050).
- Risk stratification groups were defined by ModelMT scores, and a user-friendly applet was developed for clinical application.
Conclusions:
- A novel predictive model (ModelMT) with superior performance for post-TIPS mortality has been successfully developed.
- ModelMT provides an improved tool to aid clinicians in decision-making for TIPS procedures, considering survival benefits.
- The developed applet facilitates the practical application of ModelMT in clinical settings.
