Kalo, Eric, Sturm, Lukas, Schultheiss, Michael, Moore, Oliver, Kurup, Rajiv, Gahm, Chiara, Read, Scott, Reincke, Marlene, Huber, Jan Patrick, Muller, Lukas, Kloeckner, Roman, George, Jacob, Thimme, Robert, Bettinger, Dominik, and Ahlenstiel, Golo (2024) The Freiburg Index of Post-TIPS Survival accurately predicts mortality in patients with acute decompensation of cirrhosis. Liver International, 44 (12). pp. 3229-3237.

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Abstract

Introduction: The recently developed Freiburg Index of Post-TIPS Survival (FIPS) allows improved risk classification of patients with decompensated cirrhosis allocated to transjugular intrahepatic portosystemic shunt (TIPS) implantation. This study investigated the prognostic value of the FIPS in patients hospitalized with acute decompensation of cirrhosis (AD), outside the setting of TIPS implantation.

Methods: A total of 1133 patients with AD were included in a retrospective, multi centre study. Ninety-day, 180-day and 1-year mortality were recorded and the FIPS' performance in predicting mortality at these time points was analysed using ROC analyses.

Results: Ninety-day, 180-day and 1-year mortality were 17.7%, 24.4% and 30.8%. Uni-and multivariable Cox regression models showed that the FIPS independently predicted 1-year mortality in the study cohort (HR 1.806, 95% CI 1.632–1.998, p < .0001). In ROC analyses, the FIPS offered consistently high performance in the prediction of mortality within 1 year after AD (area under the receiver operator characteristic [AUROC]: 1-year mortality .712 [.679–.746], 180-day mortality .740 [.705–.775] and 90-day mortality .761 [.721–.801]). In fact, in the subgroup of patients presenting with variceal bleeding, the FIPS even showed significantly improved discriminatory performance in the prediction of long-term mortality (AUROC 1-year mortality: .782 [.724–.839]) in comparison with established prognostic scores, such as the CLIF-C AD score (.724 [.660–.788], p = .0071) or MELD 3.0 (.726 [.662–.790], p = .0042).

Conclusions: The FIPS accurately predicts mortality in patients with AD and seems to offer superior prognostication of long-term mortality in patients with variceal bleeding.

Item ID:	86121
Item Type:	Article (Research - C1)
ISSN:	1478-3231
Keywords:	acute-on-chronic liver failure, survival, transjugular intrahepatic portosystemic shunt
Copyright Information:	This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Author(s). Liver International published by John Wiley & Sons Ltd.
Research Data:	https://onlinelibrary.wiley.com/doi/10.1111/liv.16098
Date Deposited:	17 Jul 2025 02:50
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320209 Gastroenterology and hepatology @ 90% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320222 Radiology and organ imaging @ 10%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200104 Prevention of human diseases and conditions @ 50% 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 40% 20 HEALTH > 2003 Provision of health and support services > 200304 Inpatient hospital care @ 10%
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