title: Different scoring systems in predicting survival in Chinese patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic shunt.
abstract: BACKGROUND
  Transjugular intrahepatic portosystemic shunt (TIPS) is an established minimal-invasive procedure to treat complications of portal hypertension, and several scoring systems have been used to help choose suitable patients. However, its accuracy remains controversial.
  
  
  OBJECTIVE
  To compare the performance of the Child-Turcotte-Pugh (CTP) classification system, model for end-stage liver disease (MELD) score, Emory score, Bonn TIPS early mortality (BOTEM) score, and serum bilirubin and platelet count (SB/PLT model) in predicting survival in Chinese patients with liver cirrhosis undergoing TIPS.
  
  
  METHODS
  The clinical data of patients undergoing TIPS in our department were retrospectively analyzed to compare the five scoring systems on the basis of survival after TIPS.
  
  
  RESULTS
  A cohort of 159 patients was analyzed. The survival curves showed a statistical significance between classification B and C of CTP (χ=9.451, P=0.002), between MELD less than 10 and MELD at least 10 (χ=10.099, P=0.001), and between low-risk and moderate-risk groups of the Emory score (χ=4.656, P=0.031), indicating a better discriminatory ability. By ROC curves and a logistic regression model, the MELD score and the CTP system had better power to predict 3-, 12-, and 24-month survival. The MELD score and the CTP classification system had smaller values of -2 Ln(L), Akaike Information criterion, and Schwarz-Bayesian criterion, respectively.
  
  
  CONCLUSIONS
  The MELD score and the CTP classification system provide better prognostic stratification for a cohort of Chinese patients with advanced cirrhosis undergoing TIPS. However, the MELD score is not significantly superior to the CTP system.
authors.affiliation: Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.forename: Yuzheng
authors.initials: Y
authors.lastname: Zhuge
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Zou
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
authors.forename: Chunyan
authors.initials: C
authors.lastname: Peng
authors.forename: Zhenlei
authors.initials: Z
authors.lastname: Li
authors.forename: Tingting
authors.initials: T
authors.lastname: Wang
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010976:Platelet Count; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D001663:Bilirubin