肝硬化
肝移植
内科学
布里氏评分
接收机工作特性
肝病
胃肠病学
终末期肝病模型
对数秩检验
经颈静脉肝内门体分流术
临床终点
生存分析
医学
移植
生物
随机对照试验
统计
数学
门脉高压
作者
Binlin Da,Wei Wu,Wuhua Guo,Kai Xiong,Chao Chen,Qiao Ke,Moran Zhang,Taishun Li,Jiangqiang Xiao,Lei Wang,Ming Zhang,Feng Zhang,Yuzheng Zhuge
标识
DOI:10.1038/s41598-024-64793-z
摘要
This study aimed to perform the first external validation of the modified Child-Turcotte-Pugh score based on plasma ammonia (aCTP) and compare it with other risk scoring systems to predict survival in patients with cirrhosis after transjugular intrahepatic portosystemic shunt (TIPS) placement. We retrospectively reviewed 473 patients from three cohorts between January 2016 and June 2022 and compared the aCTP score with the Child-Turcotte-Pugh (CTP) score, albumin-bilirubin (ALBI), model for end-stage liver disease (MELD) and sodium MELD (MELD-Na) in predicting transplant-free survival by the concordance index (C-index), area under the receiver operating characteristic curve, calibration plot, and decision curve analysis (DCA) curve. The median follow-up time was 29 months, during which a total of 62 (20.74%) patients died or underwent liver transplantation. The survival curves for the three aCTP grades differed significantly. Patients with aCTP grade C had a shorter expected lifespan than patients with aCTP grades A and B (P < 0.0001). The aCTP score showed the best discriminative performance using the C-index compared with other scores at each time point during follow-up, it also showed better calibration in the calibration plot and the lowest Brier scores, and it also showed a higher net benefit than the other scores in the DCA curve. The aCTP score outperformed the other risk scores in predicting survival after TIPS placement in patients with cirrhosis and may be useful for risk stratification and survival prediction.
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