Construction and validation of a mortality risk prediction model after TIPS in patients with cirrhosis,portal hypertension,and esophagogastric variceal bleeding
10.3969/j.issn.1009-9905.2025.11.003
- VernacularTitle:肝硬化门静脉高压并发EVB患者TIPS术后死亡风险预测模型的构建与验证
- Author:
Xiao-dong YANG
1
;
Zhi-gang MA
;
Xu WANG
;
Li-li LIU
;
Peng-li FENG
Author Information
1. 保定市第二中心医院 心血管科(河北 保定 072750)
- Publication Type:Journal Article
- Keywords:
Cirrhosis;
Portal hypertension;
Variceal bleeding;
TIPS;
Risk factors;
Prediction model
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(11):853-858
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify risk factors for mortality in patients with cirrhosis and portal hypertension compli-cated by esophagogastric variceal bleeding(EVB)after transjugular intrahepatic portosystemic shunt(TIPS),and to estab-lish a prediction model.Methods:Clinical data of 80 patients who underwent TIPS from March 2022 to March 2024 were retrospectively analyzed.Based on 28-day outcomes,patients were divided into survival(n=65)and death(n=15)groups.Univariate and multivariate logistic regression analyses were used to determine independent predictors,and the model's calibration and discrimination were assessed by the Hosmer-Lemeshow test and ROC curve.Results:Inde-pendent risk factors for death included Child-pugh score(OR=2.653),MELD score(OR=1.924),bleeding volume(OR=1.754),portal vein thrombosis(OR=3.247),and hepatic encephalopathy(OR=2.834).The model demonstrated good cali-bration(Hosmer-Lemeshow χ2=7.142,P=0.521)and discrimination,with an AUC of 0.873(95%CI:0.773-0.939),sensi-tivity of 83.3%,and specificity of 87.7%.Conclusion:Child-pugh score,MELD score,bleeding volume,portal vein thrombosis,and hepatic encephalopathy are independent predictors of post-TIPS mortality in cirrhotic patients with EVB.Emergency TIPS carries higher mortality risk than elective TIPS.The proposed model shows strong predictive perfor-mance and may aid in individualized prognosis assessment and therapeutic decision-making.
