Chalsani et al reported a simple score for evaluating patients with cirrhosis who have a transjugular intrahepatic shunt (TIPS). This can help to identify a patient who may require more aggressive management. The authors are from Indiana University and Emory University.
Parameters:
(1) emergency TIPS placement
(2) serum ALT in IU/L
(3) serum total bilirubin in mg/dL
(4) hepatic encephalopathy prior to TIPS and unrelated to bleeding
Parameter
Finding
Points
emergency TIPS
no
0
yes
2
serum ALT
<= 100 IU/L
0
> 100 IU/L
1
serum total bilirubin
<= 3.0 mg/dL
0
> 3.0 mg/dL
1
hepatic encephalopathy
no
0
yes
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
Total Score
Risk
6 Month Survival
24 Month Survival
0
low
90%
68%
1 to 3
medium
63%
28%
4 or 5
high
9%
NA
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