Different scoring systems in predicting survival in Chinese patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic shunt

作者：Zhang, Feng; Zhuge, Yuzheng^*; Zou, Xiaoping; Zhang, Ming; Peng, Chunyan; Li, Zhenlei; Wang, Tingting

来源：European Journal of Gastroenterology and Hepatology, 2014, 26(8): 853-860.

DOI：10.1097/MEG.0000000000000134

• liver cirrhosis
• prognosis
• scoring
• transjugular intrahepatic portosystemic shunt

Background Transjugular intrahepatic portosystemic shunt (TIPS) is an established minimal-invasive procedure to treat complications of portal hypertension, and several scoring systems have been used to help choose suitable patients. However, its accuracy remains controversial. @@@ Aim To compare the performance of the Child-Turcotte-Pugh (CTP) classification system, model for end-stage liver disease (MELD) score, Emory score, Bonn TIPS early mortality (BOTEM) score, and serum bilirubin and platelet count (SB/PLT model) in predicting survival in Chinese patients with liver cirrhosis undergoing TIPS. @@@ Patients and methods The clinical data of patients undergoing TIPS in our department were retrospectively analyzed to compare the five scoring systems on the basis of survival after TIPS. @@@ Results A cohort of 159 patients was analyzed. The survival curves showed a statistical significance between classification B and C of CTP (chi(2) = 9.451, P = 0.002), between MELD less than 10 and MELD at least 10 (chi(2) = 10.099, P = 0.001), and between low-risk and moderate-risk groups of the Emory score (chi(2) = 4.656, P = 0.031), indicating a better discriminatory ability. By ROC curves and a logistic regression model, the MELD score and the CTP system had better power to predict 3-, 12-, and 24-month survival. The MELD score and the CTP classification system had smaller values of -2 Ln(L), Akaike Information criterion, and Schwarz-Bayesian criterion, respectively. @@@ Conclusion The MELD score and the CTP classification system provide better prognostic stratification for a cohort of Chinese patients with advanced cirrhosis undergoing TIPS. However, the MELD score is not significantly superior to the CTP system.

• 出版日期2014-8
• 单位南京大学