A184 ASSOCIATION BETWEEN INDICATION FOR TIPS AND SURVIVAL IN PATIENTS WITH CIRRHOSIS: A POPULATION-BASED STUDY
Bibliographic record
Abstract
The transjugular intrahepatic portosystemic shunt (TIPS) procedure is designed to reduce portal pressure in patients with cirrhosis, thereby treating complications of portal hypertension. While several clinical trials have described the short-term outcomes following TIPS, long-term outcomes remain unclear. The aim of this study was to determine the association between indication for TIPS and long-term survival in the general population of patients with cirrhosis. We conducted a retrospective cohort study utilizing administrative health care data from Ontario, Canada accessed through the Institute of Comparative Evaluative Sciences. All patients with cirrhosis who received TIPS between January 1998 and December 2015 were included and were categorized into the following groups based on their indication for TIPS: refractory ascites and/or hepatic hydrothorax (RA/HH), variceal haemorrhage (VH), both, and other. Liver transplant-free (LTF) survival was described using Kaplan-Meier curves and the log-rank test. The association between the indication for TIPS and LTF survival was evaluated using multivariate Cox proportional hazards regression. 837 unique patients were included and the indication for TIPS was RA/HH in 52.6%, VH in 34.5%, both in 3.5% and other in 9.4%. 1-year LTF survival post-TIPS was lowest in those with both VH and RA/HH (44.0%), followed by those with only VH (54.4%), 59.0% with only RA/HH, and 63.6% for other indications (P=0.08). Using multivariate Cox regression, patients had a higher hazard of death if the indication for TIPS was both VH and RA/HH (HR 1.67, 95% CI 1.09–2.58, P=0.02) or only VH (HR 1.33, 95% CI 1.11–1.61, P=0.002) compared to patients with only RA/HH. Other factors independently associated with increased mortality included older age (HR 1.03 per year increase, 95% CI 1.02–1.04, P<0.001), Charlson-Deyo Comorbidity Index ≥4 (HR 1.32, 95% CI 1.08–1.63, P=0.008), and community hospital type (HR 1.36, 95% CI 1.09–1.69, P=0.006). Patients with an indication for TIPS related to VH are at increased risk of death following the procedure. These results can be used to target interventions towards this subset of patients following TIPS. Future studies should focus on identifying modifiable risk factors that may decrease the risk of death in this group. Southeastern Ontario Academic Medical Association New Clinician Scientist Award
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".