Nomogram for predicting survival after transjugular intrahepatic portosystemic shunt in portal hypertension patients with bleeding  

作　　者：Zhi-Bin Wang Bing Zhu Ming-Ming Meng Yi-Fan Wu Yu Zhang Dong-Ze Li Hua Tian Fu-Chuan Wang Yi-Fan Lv Qiu-Xia Ye Fu-Quan Liu 

机构地区：[1]Center for Minimally Invasive Treatment of Liver Diseases,Beijing Shijitan Hospital,Capital Medical University,Beijing 100080,China [2]Center for Diagnosis and Treatment of Hepatic Vascular Diseases,Fifth Medical Center of Chinese PLA General Hospital,Beijing 100071,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第4期58-74,共17页世界胃肠外科杂志(英文)

基　　金：Supported by the“14th Five-Year”Talent Training Program of Beijing Shijitan Hospital,Capital Medical University,No.2023 LJRCLFQ.

摘　　要：BACKGROUND Portal hypertension(PHT)is a life-threatening complication of cirrhosis,often resulting in gastrointestinal bleeding that requires transjugular intrahepatic portosystemic shunt(TIPS).While TIPS effectively reduces portal pressure,predicting long-term survival remains challenging due to the multifactorial nature of patient outcomes.Accurate survival prediction tools are lacking,and existing models often omit critical factors such as portal vein diameter.This study aimed to develop and validate a nomogram incorporating key clinical and biochemical variables to predict 1-year and 2-year survival following TIPS in PHT patients.We hypothesized that this model would provide improved risk stratification and guide clinical decisions.AIM To develop and validate a nomogram for predicting 1-year and 2-year survival in PHT patients post-TIPS.METHODS This retrospective cohort study included 848 TIPS-treated PHT patients with gastrointestinal bleeding from two tertiary hospitals(2013-2021).Mortality was the primary endpoint.Predictive variables were selected using least absolute shrinkage and selection operator regression,and a nomogram was developed with Cox regression to predict 1-year and 2-year survival.Model performance was evaluated through receiver operating characteristic curves,calibration plots,and decision curve analysis.RESULTS The mean age of the included(848)patients was 53.00 years±12.51,where 69.58%were men.Results showed that portal vein diameter,serum creatinine,potassium,and alpha-fetoprotein were the independent predictors of post-TIPS survival.Besides,the model showed strong discriminatory ability(C-index,0.816 in the training set;0.827 in the validation set)and good calibration.The area under the curve for 1-year and 2-year survival in the training set were 0.890[95%confidence interval(CI):0.802-0.948]and 0.838(95%CI:0.803-0.869),respectively.The area under the curve for 1-year and 2-year survival in the validation set were 0.934(95%CI:0.815-0.987)and 0.864(95%CI:0.811-0.907),respectively.CONC

关 键 词：Portal hypertension Gastrointestinal hemorrhage Transjugular Intrahepatic portasystemic shunt NOMOGRAMS SURVIVAL 

分 类 号：R57[医药卫生—消化系统]