Prognostic Capability of Different Liver Disease Scoring Systems for Prediction of Early Mortality after Transjugular Intrahepatic Portosystemic Shunt Creation

被引：68

作者：

Gaba, Ron C. ^{[1
]}

Couture, Patrick M. ^{[2
]}

Bui, James T. ^{[1
]}

Knuttinen, M. Grace ^{[1
]}

Walzer, Natasha M. ^{[3
]}

Kallwitz, Eric R. ^{[3
]}

Berkes, Jamie L. ^{[3
]}

Cotler, Scott J. ^{[3
]}

机构：

[1] Univ Illinois, Med Ctr Chicago, Dept Radiol, Chicago, IL 60612 USA

[2] Univ Illinois, Med Ctr Chicago, Coll Med, Chicago, IL 60612 USA

[3] Univ Illinois, Med Ctr Chicago, Dept Med, Hepatol Sect, Chicago, IL 60612 USA

来源：

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY | 2013年 / 24卷 / 03期

关键词：

POLYTETRAFLUOROETHYLENE-COVERED STENT; HEPATIC-ENCEPHALOPATHY; CHILD-PUGH; MELD SCORE; APACHE-II; SURVIVAL; MODEL; TIPS; MULTICENTER; CIRRHOSIS;

D O I：

10.1016/j.jvir.2012.10.026

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To compare the performance of various liver disease scoring systems in predicting early mortality after transjugular intrahepatic portosystemic shunt (TIPS) creation. Materials and Methods: In this single-institution retrospective study, eight scoring systems were used to grade liver disease in 211 patients (male-to-female ratio = 131:80; mean age, 54 y) before TIPS creation from 1999-2011. Scoring systems included bilirubin level, Child-Pugh (CP) score, Model for End-Stage Liver Disease (MELD) and Model for End-Stage Liver Disease sodium (MELD-Na) score, Emory score, prognostic index (PI), Acute Physiology and Chronic Health Evaluation (APACHE) 2 score, and Bonn TIPS early mortality (BOTEM) score. Medical record review was used to identify 30-day and 90-day clinical outcomes. The relationship of scoring parameters with mortality outcomes was assessed with multivariate analysis, and the relative ability of systems to predict mortality after TIPS creation was evaluated by comparing area under receiver operating characteristic (AUROC) curves. Results: TIPS were successfully created for variceal hemorrhage (n = 121), ascites (n = 72), hepatic hydrothorax (n. = 15), and portal vein thrombosis (n = 3). All scoring systems had a significant association with 30-day and 90-day mortality (P < .050 in each case) on multivariate analysis. Based on 30-day and 90-day AUROC, MELD (0.878, 0.816) and MELD-Na (0.863, 0.823) scores had the best capability to predict early mortality compared with bilirubin (0.786, 0.749), CP (0.822, 0.771), Emory (0.786, 0.681), PI (0.854, 0.760), APACHE 2 (0.836, 0.735), and BOTEM (0.798, 0.698), with statistical superiority over bilirubin, Emory, and BOTEM scores. Conclusions: Several liver disease scoring systems have prognostic value for early mortality after TIPS creation. MELD and MELD-Na scores most effectively predict survival after TIPS creation.

引用

页码：411 / 420

页数：10

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