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Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival

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Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival. / Bettinger, Dominik; Sturm, Lukas; Pfaff, Lena; Hahn, Felix; Kloeckner, Roman; Volkwein, Lara; Praktiknjo, Michael; Lv, Yong; Han, Guohong; Huber, Jan Patrick; Boettler, Tobias; Reincke, Marlene; Klinger, Christoph; Caca, Karel; Heinzow, Hauke; Seifert, Leon Louis; Weiss, Karl Heinz; Rupp, Christian; Piecha, Felix; Kluwe, Johannes; Zipprich, Alexander; Luxenburger, Hendrik; Neumann-Haefelin, Christoph; Schmidt, Arthur; Jansen, Christian; Meyer, Carsten; Uschner, Frank E; Brol, Maximilian J; Trebicka, Jonel; Rössle, Martin; Thimme, Robert; Schultheiss, Michael.

In: J HEPATOL, Vol. 74, No. 6, 06.2021, p. 1362-1372.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Bettinger, D, Sturm, L, Pfaff, L, Hahn, F, Kloeckner, R, Volkwein, L, Praktiknjo, M, Lv, Y, Han, G, Huber, JP, Boettler, T, Reincke, M, Klinger, C, Caca, K, Heinzow, H, Seifert, LL, Weiss, KH, Rupp, C, Piecha, F, Kluwe, J, Zipprich, A, Luxenburger, H, Neumann-Haefelin, C, Schmidt, A, Jansen, C, Meyer, C, Uschner, FE, Brol, MJ, Trebicka, J, Rössle, M, Thimme, R & Schultheiss, M 2021, 'Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival', J HEPATOL, vol. 74, no. 6, pp. 1362-1372. https://doi.org/10.1016/j.jhep.2021.01.023

APA

Bettinger, D., Sturm, L., Pfaff, L., Hahn, F., Kloeckner, R., Volkwein, L., Praktiknjo, M., Lv, Y., Han, G., Huber, J. P., Boettler, T., Reincke, M., Klinger, C., Caca, K., Heinzow, H., Seifert, L. L., Weiss, K. H., Rupp, C., Piecha, F., ... Schultheiss, M. (2021). Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival. J HEPATOL, 74(6), 1362-1372. https://doi.org/10.1016/j.jhep.2021.01.023

Vancouver

Bettinger D, Sturm L, Pfaff L, Hahn F, Kloeckner R, Volkwein L et al. Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival. J HEPATOL. 2021 Jun;74(6):1362-1372. https://doi.org/10.1016/j.jhep.2021.01.023

Bibtex

@article{b270307c039b46e19df8aab84eb58bd5,
title = "Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival",
abstract = "BACKGROUND & AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is an effective and safe treatment for complications of portal hypertension. Survival prediction is important in these patients as they constitute a high-risk population. Therefore, the aim of our study was to develop an alternative prognostic model for accurate survival prediction after planned TIPS implantation.METHODS: A total of 1,871 patients with de novo TIPS implantation for ascites or secondary prophylaxis of variceal bleeding were recruited retrospectively. The study cohort was divided into a training set (80% of study patients; n = 1,496) and a validation set (20% of study patients; n = 375). Further, patients with early (preemptive) TIPS implantation due to variceal bleeding were included as another validation cohort (n = 290). Medical data and overall survival (OS) were assessed. A Cox regression model was used to create an alternative prediction model, which includes significant prognostic factors.RESULTS: Age, bilirubin, albumin and creatinine were the most important prognostic factors. These parameters were included in a new score named the Freiburg index of post-TIPS survival (FIPS). The FIPS score was able to identify high-risk patients with a significantly reduced median survival of 5.0 (3.1-6.9) months after TIPS implantation in the training set. These results were confirmed in the validation set (median survival of 3.1 [0.9-5.3] months). The FIPS score showed better prognostic discrimination compared to the Child-Pugh, MELD, MELD-Na score and the bilirubin-platelet model. However, the FIPS score showed insufficient prognostic discrimination in patients with early TIPS implantation.CONCLUSIONS: The FIPS score is superior to established scoring systems for the identification of high-risk patients with a worse prognosis following elective TIPS implantation.LAY SUMMARY: Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective treatment for patients with cirrhosis and clinically significant portal hypertension. However, risk stratification is a major challenge in these patients as currently available scoring systems have major drawbacks. Age, bilirubin, albumin and creatinine were included in a new risk score which was named the Freiburg index of post-TIPS survival (FIPS). The FIPS score can identify patients at high risk and may guide clinical decision making.",
author = "Dominik Bettinger and Lukas Sturm and Lena Pfaff and Felix Hahn and Roman Kloeckner and Lara Volkwein and Michael Praktiknjo and Yong Lv and Guohong Han and Huber, {Jan Patrick} and Tobias Boettler and Marlene Reincke and Christoph Klinger and Karel Caca and Hauke Heinzow and Seifert, {Leon Louis} and Weiss, {Karl Heinz} and Christian Rupp and Felix Piecha and Johannes Kluwe and Alexander Zipprich and Hendrik Luxenburger and Christoph Neumann-Haefelin and Arthur Schmidt and Christian Jansen and Carsten Meyer and Uschner, {Frank E} and Brol, {Maximilian J} and Jonel Trebicka and Martin R{\"o}ssle and Robert Thimme and Michael Schultheiss",
note = "Copyright {\textcopyright} 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.",
year = "2021",
month = jun,
doi = "10.1016/j.jhep.2021.01.023",
language = "English",
volume = "74",
pages = "1362--1372",
journal = "J HEPATOL",
issn = "0168-8278",
publisher = "Elsevier",
number = "6",

}

RIS

TY - JOUR

T1 - Refining prediction of survival after TIPS with the novel Freiburg index of post-TIPS survival

AU - Bettinger, Dominik

AU - Sturm, Lukas

AU - Pfaff, Lena

AU - Hahn, Felix

AU - Kloeckner, Roman

AU - Volkwein, Lara

AU - Praktiknjo, Michael

AU - Lv, Yong

AU - Han, Guohong

AU - Huber, Jan Patrick

AU - Boettler, Tobias

AU - Reincke, Marlene

AU - Klinger, Christoph

AU - Caca, Karel

AU - Heinzow, Hauke

AU - Seifert, Leon Louis

AU - Weiss, Karl Heinz

AU - Rupp, Christian

AU - Piecha, Felix

AU - Kluwe, Johannes

AU - Zipprich, Alexander

AU - Luxenburger, Hendrik

AU - Neumann-Haefelin, Christoph

AU - Schmidt, Arthur

AU - Jansen, Christian

AU - Meyer, Carsten

AU - Uschner, Frank E

AU - Brol, Maximilian J

AU - Trebicka, Jonel

AU - Rössle, Martin

AU - Thimme, Robert

AU - Schultheiss, Michael

N1 - Copyright © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - BACKGROUND & AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is an effective and safe treatment for complications of portal hypertension. Survival prediction is important in these patients as they constitute a high-risk population. Therefore, the aim of our study was to develop an alternative prognostic model for accurate survival prediction after planned TIPS implantation.METHODS: A total of 1,871 patients with de novo TIPS implantation for ascites or secondary prophylaxis of variceal bleeding were recruited retrospectively. The study cohort was divided into a training set (80% of study patients; n = 1,496) and a validation set (20% of study patients; n = 375). Further, patients with early (preemptive) TIPS implantation due to variceal bleeding were included as another validation cohort (n = 290). Medical data and overall survival (OS) were assessed. A Cox regression model was used to create an alternative prediction model, which includes significant prognostic factors.RESULTS: Age, bilirubin, albumin and creatinine were the most important prognostic factors. These parameters were included in a new score named the Freiburg index of post-TIPS survival (FIPS). The FIPS score was able to identify high-risk patients with a significantly reduced median survival of 5.0 (3.1-6.9) months after TIPS implantation in the training set. These results were confirmed in the validation set (median survival of 3.1 [0.9-5.3] months). The FIPS score showed better prognostic discrimination compared to the Child-Pugh, MELD, MELD-Na score and the bilirubin-platelet model. However, the FIPS score showed insufficient prognostic discrimination in patients with early TIPS implantation.CONCLUSIONS: The FIPS score is superior to established scoring systems for the identification of high-risk patients with a worse prognosis following elective TIPS implantation.LAY SUMMARY: Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective treatment for patients with cirrhosis and clinically significant portal hypertension. However, risk stratification is a major challenge in these patients as currently available scoring systems have major drawbacks. Age, bilirubin, albumin and creatinine were included in a new risk score which was named the Freiburg index of post-TIPS survival (FIPS). The FIPS score can identify patients at high risk and may guide clinical decision making.

AB - BACKGROUND & AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is an effective and safe treatment for complications of portal hypertension. Survival prediction is important in these patients as they constitute a high-risk population. Therefore, the aim of our study was to develop an alternative prognostic model for accurate survival prediction after planned TIPS implantation.METHODS: A total of 1,871 patients with de novo TIPS implantation for ascites or secondary prophylaxis of variceal bleeding were recruited retrospectively. The study cohort was divided into a training set (80% of study patients; n = 1,496) and a validation set (20% of study patients; n = 375). Further, patients with early (preemptive) TIPS implantation due to variceal bleeding were included as another validation cohort (n = 290). Medical data and overall survival (OS) were assessed. A Cox regression model was used to create an alternative prediction model, which includes significant prognostic factors.RESULTS: Age, bilirubin, albumin and creatinine were the most important prognostic factors. These parameters were included in a new score named the Freiburg index of post-TIPS survival (FIPS). The FIPS score was able to identify high-risk patients with a significantly reduced median survival of 5.0 (3.1-6.9) months after TIPS implantation in the training set. These results were confirmed in the validation set (median survival of 3.1 [0.9-5.3] months). The FIPS score showed better prognostic discrimination compared to the Child-Pugh, MELD, MELD-Na score and the bilirubin-platelet model. However, the FIPS score showed insufficient prognostic discrimination in patients with early TIPS implantation.CONCLUSIONS: The FIPS score is superior to established scoring systems for the identification of high-risk patients with a worse prognosis following elective TIPS implantation.LAY SUMMARY: Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective treatment for patients with cirrhosis and clinically significant portal hypertension. However, risk stratification is a major challenge in these patients as currently available scoring systems have major drawbacks. Age, bilirubin, albumin and creatinine were included in a new risk score which was named the Freiburg index of post-TIPS survival (FIPS). The FIPS score can identify patients at high risk and may guide clinical decision making.

U2 - 10.1016/j.jhep.2021.01.023

DO - 10.1016/j.jhep.2021.01.023

M3 - SCORING: Journal article

C2 - 33508376

VL - 74

SP - 1362

EP - 1372

JO - J HEPATOL

JF - J HEPATOL

SN - 0168-8278

IS - 6

ER -