A Novel Score for Predicting Long-Term Outcomes in Recanalisation-Treated Patients With Budd-Chiari Syndrome: A...

Area of Science:

• Hepatology
• Interventional Radiology
• Medical Statistics

Background:

• Budd-Chiari syndrome (BCS) lacks a specific recanalisation model.
• Individualized long-term outcome prediction and risk stratification are needed for BCS patients.

Purpose of the Study:

• To develop and validate a novel prognostic score for BCS patients undergoing recanalisation.
• To compare the novel score with existing BCS prognostic models.

Main Methods:

• A cohort of 834 BCS patients undergoing recanalisation from six Chinese centers (January 2010 - May 2019) was analyzed.
• Cox multivariable regression and a 1000-times bootstrapped internal validation were employed.
• The developed score was compared with existing models like the Clichy score.

Main Results:

• The BCS-Recanalisation score, incorporating variceal bleeding history, ascites, albumin, creatinine, urea, WBC, and alkaline phosphatase, showed good discrimination (C-index: 0.74).
• Patients were stratified into low, intermediate, and high-risk groups with significantly different 5-year TIPS-free survival rates (92.2%, 84.7%, 67.8%).
• The score outperformed existing models in predicting TIPS-free survival and other outcomes.

Conclusions:

• The BCS-Recanalisation score provides accurate individualised outcome prediction and risk stratification for recanalisation-treated BCS patients.
• The score demonstrates potential for clinical application in managing BCS.
• External validation is recommended for future studies.