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- Title
A modified model for predicting mortality after transjugular intrahepatic portosystemic shunt: A multicentre study.
- Authors
Zhao; Yang Yang; Weifu Lv; Siyu Zhu; Xiaoqiong Chen; Tao Wang; Mingsheng Huang; Taixue An; Chongyang Duan; Xiangrong Yu; Qiyang Li; Jinqiang Chen; Junyang Luo; Shuoling Zhou; Ligong Lu; Meiyan Huang; Sirui Fu
- Abstract
Background and Aims: The transjugular intrahepatic portosystemic shunt has controversial survival benefits; thus, patient screening should be performed preoperatively. In this study, we aimed to develop a model to predict post-transjugular intrahepatic portosystemic shunt mortality to aid clinical decision making. Methods: A total of 811 patients undergoing transjugular intrahepatic portosystemic shunt from five hospitals were divided into the training and external validation data sets. A modified prediction model of post-transjugular intrahepatic portosystemic shunt mortality (ModelMT) was built after performing logistic regression. To verify the improved performance of ModelMT, we compared it with seven previous models, both in discrimination and calibration. Furthermore, patients were stratified into low-, medium-, high- and extremely high-risk subgroups. Results: ModelMT demonstrated a satisfying predictive efficiency in both discrimination and calibration, with an area under the curve of .875 in the training set and .852 in the validation set. Compared to previous models (ALBI, BILI-PLT, MELD-Na, MOTS, FIPS, MELD, CLIF-C AD), ModelMT showed superior performance in discrimination by statistical difference in the Delong test, net reclassification improvement and integrated discrimination improvement (all p < .050). Similar results were observed in calibration. Low-, medium-, high- and extremely high-risk groups were defined by scores of ≤160, 160--180, 180--200 and >200, respectively. To facilitate future clinical application, we also built an applet for ModelMT. Conclusions: We successfully developed a predictive model with improved performance to assist in decision making for transjugular intrahepatic portosystemic shunt according to survival benefits.
- Subjects
DECISION making; MORTALITY; LOGISTIC regression analysis; FORECASTING; PREDICTION models; TRANSTHEORETICAL model of change
- Publication
Liver International, 2024, Vol 44, Issue 2, p472
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.15790