Validation of prognostic indices in Egyptian Budd-Chiari syndrome patients: A single-center study

Abstract

AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTSThe overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.CONCLUSIONThe New Clichy score could independently predict the one-year survival in Egyptian BCS patients.

Presence of Ascites at Presentation is Associated With Absence of Long-Term Response Amongst Patients With Budd-Chiari Syndrome When Treated With Medical Therapy Alone: A Single Centre Real-Life Experience

“…77% in different studies. [3][4][5][16][17][18] The survival rate in our study is similar to reported data from a study by Zietoun et al and in a meta-analysis done by Qi et al 7,19 . There was poor overall discriminative ability of various predictive scores to predict survival (AUROC, 0.550-0.651) 22 .…”

Liver and Spleen Stiffness Measurements for Assessment of Portal Hypertension Severity in Patients with Budd Chiari Syndrome

“…To date, various prognostic indices (PIs) similar to the Child-Pugh classification, such as the Rotterdam [2] or Clichy Score [3], have been proposed to predict transplantation- (OLT-) free or overall survival in BCS patients [1]. However, these PIs have a relatively low predictive ability [4, 5] and are thus not suitable for an individual prognostic assessment and management [1]. Moreover, no specific noninvasive predictors of recanalization, portal hypertension (PH) severity, risk of decompensation event, or transjugular-intrahepatic-portosystemic shunt (TIPS) dysfunction are available.…”

A case report of Budd-Chiari syndrome with cardiac complications and low SpO2 successfully managed by an Integrated-approach

“…BCS is a rare disease caused by occlusion of the inferior venacava or hepatic vein. As per the retrospective study on 194 Primary BCS cases in Egypt, the one-year survival rate of the noninterventional group is only 31.7%, and the estimated mean survival time was 9.84 months [11].…”

“…As per the Egyptian study, the Child-Pugh score of 10.17±2.28 and the Clichy Prognostic index score of 5.89±1.09 did not survive for more than one year. The diagnostic performance of prognostic indices -Child-Pugh score and Clichy Prognostic index for prediction of one-year survival among the studied population revealed cut-off scores of ≥8.55 and ≥3.75, respectively[11].…”