A novel Chongqing index of post-TIPS survival for predicting survival in Chinese cirrhotic patients after transjugular intrahepatic portosystemic shunt: A multicenter, retrospective study

Abstract

Abstract Background & Aims: Transjugular intrahepatic portosystemic shunt is an important method for the treatment of complications related to portal hypertension. However, a prediction model based on Chinese population has not been established. The aim of our study was to develop a prognostic model based on the Chinese population. Methods: We screened cirrhotic patients received TIPS between January 2014 and December 2021 at 11 hospitals in China and collected the available clinical data of all eligible patients. Using random assignment, patients were divided into training and validation cohorts in a 7:3 ratio. Independent risk factors for prognosis were screened by multivariate Cox regression and were used to develop a nomogram based on the training cohort. Validation cohort data was used to conduct external validation. Results: A total of 794 patients were recruited, 556 in the training cohort and 238 in the validation cohort. Age, ascites, serum albumin, total bilirubin and serum sodium levels were independent prognostic factors, and these variables were incorporated to establish nomogram scoring model named the Chongqing index of post-TIPS survival (CIPS). The C-indices were 0.753 [0.684-0.812] in the training cohort and 0.786 [0.715-0.857] in the validation cohort. Compared with the Child-Pugh, iMELD, ALBI and FIPS scores, the CIPS showed better prognosis discrimination at 1 and 3 years after TIPS. The CIPS could identify high-risk patients after TIPS implantation with a cutoff point of 149. Conclusion: The CIPS is more superior to predict 1-year and 3-years survival in Chinese patient cohorts and can identify high-risk patients with poor prognosis after TIPS implantation, which can be used to guide clinical patient management.