title: Prognostic factors in patients with refractory ascites treated by transjugular intrahepatic porto-systemic shunt: From the liver to the kidney.
abstract: BACKGROUND
  The aim of this retrospective study was to evaluate the prognostic value of different scores (including Child-Pugh and Model for End Stage Liver Diseases) in cirrhotic patients treated with transjugular intrahepatic porto-systemic shunt for refractory ascites.
  
  
  METHODS
  Overall, 111 patients with transjugular intrahepatic porto-systemic shunt insertion between January 1998 and July 2012 were included.
  
  
  RESULTS
  Survival rates (without transplantation) were 82.0% at 3 months, and 59.4% at 1 year. In addition to standard parameters, a new simple classification based on platelet count and glomerular filtration rate showed strong prognostic ability and could distinguish 3 groups of patients (Log-rank test, p<0.001): a "good-prognosis" group with platelet counts above 125×10(9)L(-1) and a glomerular filtration rate above 90 mL/min (1-year survival rate 92%), a "poor-prognosis" group with platelet counts below 125×10(9)L(-1) and a glomerular filtration rate below 90 mL/min (1-year survival rate 34.8%), and an "intermediate-prognosis" group (1-year survival rate 58.2%). Multivariate analysis showed a hazard ratio of 6.34 for the intermediate class and of 12.623 for the high class.
  
  
  CONCLUSIONS
  A new and simple classification including platelet count and glomerular filtration rate is highly predictive of survival in patients with refractory ascites treated with transjugular intrahepatic porto-systemic shunt and could be used to select patients for this procedure.
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hamel
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Guillaud
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Roman
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Vallin
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Pilleul
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Valette
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Henry
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Guibal
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France; Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: François
authors.initials: F
authors.lastname: Mion
authors.affiliation: Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital, France; Claude Bernard Lyon 1 University, Lyon, France. Electronic address: jerome.dumortier@chu-lyon.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001201:Ascites / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D001707:Biopsy, Needle; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000601:surgery; D008099:Liver / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Ascitis; Cirrhosis; Survival; TIPS