Evidence map›Paper›PMID 37035274›Full record

ArticleWorld journal of gastrointestinal pathophysiology2023

Novel CABIN score outperforms other prognostic models in predicting in-hospital mortality after salvage transjugular intrahepatic portosystemic shunting.

Jake Krige, Eduard Jonas, Chanel Robinson, Steve Beningfield, Urda Kotze, Marc Bernon, Sean Burmeister, Christo Kloppers

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Article in World journal of gastrointestinal pathophysiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Jake KrigeDepartment of Surgical Gastroenterology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa. jej.krige@uct.ac.za.
Eduard JonasDepartment of Surgical Gastroenterology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa.
Chanel RobinsonDepartment of Surgical Gastroenterology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa.
Steve BeningfieldDepartment of Radiology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa.
Urda KotzeDepartment of Surgical Gastroenterology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa.
Marc BernonDepartment of Surgical Gastroenterology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa.
Sean BurmeisterDepartment of Surgical Gastroenterology, University of Cape Town Health Sciences Faculty, Cape Town 7925, Western Cape, South Africa.
Christo KloppersDepartment of Surgical Gastroenterology, University of Cape Town, Faculty of Health Sciences, Cape Town 7925, Western Cape, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransjugular intrahepatic portosystemic shunt (TIPS) is now established as the salvage procedure of choice in patients who have uncontrolled or severe recurrent variceal bleeding despite optimal medical and endoscopic treatment.

aimTo analysis compared the performance of eight risk scores to predict in-hospital mortality after salvage TIPS (sTIPS) placement in patients with uncontrolled variceal bleeding after failed medical treatment and endoscopic intervention.

methodsBaseline risk scores for the Acute Physiology and Chronic Health Evaluation (APACHE) II, Bonn TIPS early mortality (BOTEM), Child-Pugh, Emory, FIPS, model for end-stage liver disease (MELD), MELD-Na, and a novel 5 category CABIN score incorporating Creatinine, Albumin, Bilirubin, INR and Na, were calculated before sTIPS. Concordance (C) statistics for predictive accuracy of in-hospital mortality of the eight scores were compared using area under the receiver operating characteristic curve (AUROC) analysis.

resultsThirty-four patients (29 men, 5 women), median age 52 years (range 31-80) received sTIPS for uncontrolled (11) or refractory (23) bleeding between August 1991 and November 2020. Salvage TIPS controlled bleeding in 32 (94%) patients with recurrence in one. Ten (29%) patients died in hospital. All scoring systems had a significant association with in-hospital mortality (

conclusionThe novel CABIN score had the best prediction capability with statistical superiority over seven other risk scores. Despite sTIPS, hospital mortality remains high and can be predicted by CABIN category B or C or CABIN scores > 10. Survival was 100% in CABIN A patients while mortality was 75% for CABIN B, 87.5% for CABIN C, and 83% for CABIN scores > 10.

Indexed as

MortalityPortal hypertensionRisk scoreTransjugular intrahepatic portosystemic shuntVariceal bleeding

Identifiers

PMID37035274
PMCPMC10074947

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