Akash Singh, MBBS, Richard Kalman, MD Einstein Healthcare Network, Philadelphia, PA
Introduction: The model for end-stage liver disease (MELD) score has long been the standard for predicting mortality following transjugular intrahepatic portosystemic shunt (TIPS) placement. This study aims to compare the effectiveness of the MELD, sodium MELD (MELD-Na) and MELD 3.0 scoring systems in predicting post-TIPS outcomes.
Methods: A retrospective chart review was conducted including patients who underwent TIPS placement between 2018 and 2023 at our institution. The primary outcome was mortality at 30, 90 and 365 days. We performed receiver operating characteristic (ROC) curve analysis to assess the performance of MELD, MELD-Na and MELD 3.0.
Results: There were 97 patients included in the study. Mortality rates in 30, 90 and 365 days after TIPS placement were 12% (12), 17% (16) and 26% (23). Simple logistic regression showed that MELD, MELD-Na and MELD 3.0 scores predicted 30, 90 and 365-day mortality. In comparing the ROC AUCs for MELD, MELD-Na and MELD 3.0, they were similar in predicting 30-day mortality (p=0.002, p=0.001, p=0.001, respectively), 90-day mortality (p=0.002, p=0.001, p=0.001, respectively) and 365-day mortality (p=0.01, p=0.009, p=0.007, respectively). Overall 30-day readmission rate after TIPS placement was 45%. MELD, MELD-Na and MELD 3.0 were similar in predicting 30-day readmission after TIPS placement (p=0.68, p=0.42, p=0.13, respectively).
Discussion: Findings from our study indicate that the MELD, MELD-Na, and MELD 3.0 scores are comparable in predicting both short-term and long-term mortality. However, none of these scores demonstrated predictive value for 30-day readmission following TIPS procedures.
Figure: ROC for 30, 90 and 365 day mortality, along with ROC for 30 day readmission post-TIPS.
Disclosures:
Akash Singh indicated no relevant financial relationships.
Richard Kalman indicated no relevant financial relationships.
Akash Singh, MBBS, Richard Kalman, MD. P2914 - Comparative Analysis of MELD, MELD-Na and MELD 3.0 Scores in Predicting Outcomes After TIPS Placement, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
