Prognostic value of the CLIF‐C AD score in patients with implantation of transjugular intrahepatic portosystemic shunt

Abstract: Prognostic assessment of patients with liver cirrhosis allocated for implantation of a transjugular intrahepatic portosystemic shunt (TIPS) is a challenging task in clinical practice. The aim of our study was to assess the prognostic value of the CLIF-C AD (Acute Decompensation) score in patients with TIPS implantation. Transplant-free survival (TFS) and 3-month mortality were reviewed in 880 patients who received de novo TIPS implantation for the treatment of cirrhotic portal hypertension. The prognostic value of the CLIF-C AD score was compared with the Model for End-Stage Liver Disease (MELD) score, Child-Pugh score, and albumin-bilirubin (ALBI) score using Harrell’s C concordance index. The median TFS after TIPS implantation was 40.0 (34.6-45.4) months. The CLIF-C AD score (c = 0.635 [0.609-0.661]) was superior in the prediction of TFS in comparison to MELD score (c = 0.597 [0.570-0.623], P = 0.006), Child-Pugh score (c = 0.579 [0.552-0.606], P < 0.001), and ALBI score (c = 0.573 [0.545-0.600], P < 0.001). However, the CLIF-C AD score did not perform significantly better than the MELD-Na score (c = 0.626 [0.599-0.653], P = 0.442). There were no profound differences in the scores’ ranking with respect to indication for TIPS implantation, stent type, or underlying liver disease. Subgroup analyses revealed that a CLIF-C AD score >45 was a predictor of 3-month mortality in the supposed low-risk group of patients with a MELD score ≤12 (14.7% vs. 5.1%, P < 0.001). Conclusion: The CLIF-C AD score is suitable for prognostic assessment of patients with cirrhotic portal hypertension receiving TIPS implantation. In the prediction of TFS, the CLIF-C AD score is superior to MELD score, Child-Pugh score, and ALBI score but not the MELD-Na score

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: Hepatology communications. - 5, 4 (2021) , 650-660, ISSN: 2471-254X

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2021
• Creator: Sturm, Lukas ; Praktiknjo, Michael ; Bettinger, Dominik ; Huber, Jan Patrick ; Volkwein, Lara ; Schmidt, Arthur ; Käser, Rafael Simon Peter ; Chang, Johannes ; Jansen, Christian ; Meyer, Carsten ; Thomas, Daniel K. ; Thimme, Robert ; Trebicka, Jonel ; Schultheiß, Michael

Further information

• DOI: 10.1002/hep4.1654
• URN: urn:nbn:de:bsz:25-freidok-1761143
• Rights: Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 22.09.2026, 12:55 PM CEST