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The Freiburg Index of Post-TIPS Survival accurately predicts mortality in patients with acute decompensation of cirrhosis.
Kalo, Eric; Sturm, Lukas; Schultheiss, Michael; Moore, Oliver; Kurup, Rajiv; Gahm, Chiara; Read, Scott; Reincke, Marlene; Huber, Jan Patrick; Müller, Lukas; Kloeckner, Roman; George, Jacob; Thimme, Robert; Bettinger, Dominik; Ahlenstiel, Golo.
Afiliación
  • Kalo E; Blacktown Mount Druitt Clinical School and Research Centre, Western Sydney University, Blacktown, New South Wales, Australia.
  • Sturm L; Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia.
  • Schultheiss M; Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Moore O; Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Kurup R; Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Gahm C; Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Read S; Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia.
  • Reincke M; Blacktown Mount Druitt Clinical School and Research Centre, Western Sydney University, Blacktown, New South Wales, Australia.
  • Huber JP; Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia.
  • Müller L; Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Kloeckner R; Blacktown Mount Druitt Clinical School and Research Centre, Western Sydney University, Blacktown, New South Wales, Australia.
  • George J; Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia.
  • Thimme R; Storr Liver Unit, Westmead Institute for Medical Research, Westmead, New South Wales, Australia.
  • Bettinger D; Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Ahlenstiel G; Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Liver Int ; 2024 Sep 09.
Article en En | MEDLINE | ID: mdl-39248164
ABSTRACT

INTRODUCTION:

The recently developed Freiburg Index of Post-TIPS Survival (FIPS) allows improved risk classification of patients with decompensated cirrhosis allocated to transjugular intrahepatic portosystemic shunt (TIPS) implantation. This study investigated the prognostic value of the FIPS in patients hospitalized with acute decompensation of cirrhosis (AD), outside the setting of TIPS implantation.

METHODS:

A total of 1133 patients with AD were included in a retrospective, multi-centre study. Ninety-day, 180-day and 1-year mortality were recorded and the FIPS' performance in predicting mortality at these time points was analysed using ROC analyses.

RESULTS:

Ninety-day, 180-day and 1-year mortality were 17.7%, 24.4% and 30.8%. Uni- and multivariable Cox regression models showed that the FIPS independently predicted 1-year mortality in the study cohort (HR 1.806, 95% CI 1.632-1.998, p < .0001). In ROC analyses, the FIPS offered consistently high performance in the prediction of mortality within 1 year after AD (area under the receiver operator characteristic [AUROC] 1-year mortality .712 [.679-.746], 180-day mortality .740 [.705-.775] and 90-day mortality .761 [.721-.801]). In fact, in the subgroup of patients presenting with variceal bleeding, the FIPS even showed significantly improved discriminatory performance in the prediction of long-term mortality (AUROC 1-year mortality .782 [.724-.839]) in comparison with established prognostic scores, such as the CLIF-C AD score (.724 [.660-.788], p = .0071) or MELD 3.0 (.726 [.662-.790], p = .0042).

CONCLUSIONS:

The FIPS accurately predicts mortality in patients with AD and seems to offer superior prognostication of long-term mortality in patients with variceal bleeding.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Liver Int Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Liver Int Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos