Interpretable prediction model for short- and long-term hepatic encephalopathy and variceal rebleeding after TIPS: a real-world study
{"INTRODUCTION:":[0],"Transjugular":[1],"intrahepatic":[2],"portosystemic":[3],"shunt":[4],"(TIPS)":[5],"relieves":[6],"portal":[7,190,197],"hypertension,":[8],"but":[9],"post-TIPS":[10,231],"overt":[11],"hepatic":[12],"encephalopathy":[13],"(OHE)":[14,141],"and":[15,31,40,43,89,102,117,121,129,142,148,150,166,212,229,233,241],"variceal":[16],"rebleeding":[17],"(VRB)":[18,144],"remain":[19],"outcomes":[20],"that":[21],"significantly":[22],"impair":[23],"survival.":[24],"We":[25],"aimed":[26],"to":[27,127],"identify":[28],"risk":[29,243],"factors":[30],"develop":[32],"an":[33,76],"interpretable":[34,221],"machine":[35,78],"learning":[36,79],"model":[37,73,223],"predicting":[38],"2-":[39,228],"6-year":[41,230],"OHE":[42,116,158,211,232],"VRB.":[44],"METHODS:":[45],"In":[46],"this":[47],"multicenter":[48],"retrospective":[49],"study,":[50],"636":[51],"patients":[52],"undergoing":[53],"TIPS":[54],"(2014-2023)":[55],"with":[56,91],"2-6":[57],"years":[58,165],"follow-up":[59],"were":[60,100,107],"analyzed.":[61],"A":[62],"detailed":[63],"perioperative":[64],"dataset":[65],"was":[66,85,119],"curated.":[67],"LASSO":[68],"selected":[69],"key":[70],"predictors":[71],"for":[72,109,157,176,179,210,215,227,239],"training":[74],"in":[75,189,196],"integrated":[77],"voting":[80],"ensemble":[81],"(ML-VE)":[82],"framework.":[83],"Efficacy":[84],"assessed":[86],"by":[87],"AUC":[88],"compared":[90],"conventional":[92,172],"clinical":[93],"scores":[94,173],"(Child-Pugh,":[95],"MELD,":[96],"MELD-Na).":[97],"Subgroup":[98],"analyses":[99],"conducted,":[101],"SHapley":[103],"Additive":[104],"exPlanations":[105],"(SHAP)":[106],"used":[108],"interpretation.":[110],"RESULTS:":[111],"The":[112,220],"cumulative":[113],"incidence":[114],"of":[115,139,161],"VRB":[118,194,216,234],"22.2%":[120],"8.2%":[122],"at":[123,131,145,152,163,168,217],"2":[124,146,164],"years,":[125,133,147,170],"increasing":[126],"24.8%":[128],"10.1%":[130],"6":[132,153,169],"respectively.":[134],"Internally,":[135],"ML-VE":[136,222],"achieved":[137],"AUCs":[138,160],"0.960":[140],"0.966":[143],"0.849(OHE)":[149],"0.828(VRB)":[151],"years;":[154],"external":[155],"validation":[156],"yielded":[159],"0.914":[162],"0.924":[167],"outperforming":[171],"(AUC":[174],"0.528-0.563":[175],"OHE;":[177],"0.528-0.555":[178],"VRB).":[180],"All":[181],"prespecified":[182],"subgroups":[183],"had":[184],"2-year":[185],"AUCs≥0.93":[186],"(OHE":[187],"prediction":[188,195],"vein":[191],"thrombosis:":[192],"0.993;":[193],"pressure":[198],"gradient":[199],"9-12":[200],"mmHg:":[201],"0.987).":[202],"SHAP":[203],"identified":[204],"\\"diabetes\\"":[205],"as":[206],"the":[207],"strongest":[208],"predictor":[209],"\\"recent":[213],"bleeding\\"":[214],"2-years.":[218],"CONCLUSIONS:":[219],"showed":[224],"good":[225],"discrimination":[226],"risk,":[235],"suggesting":[236],"potential":[237],"utility":[238],"short-":[240],"long-term":[242],"stratification":[244],"after":[245],"TIPS.":[246]}
Authors
- Min Zhang (ORCID: https://orcid.org/0000-0003-3568-7351)
- Bin Song (ORCID: https://orcid.org/0000-0002-7269-2101)
- Xiao Zhang (ORCID: https://orcid.org/0000-0002-4703-8407)
- Jianyu Li (ORCID: https://orcid.org/0000-0002-1128-6804)
- Longbin Zhang (ORCID: https://orcid.org/0000-0002-8930-6246)
- Shang Wan (ORCID: https://orcid.org/0000-0001-9182-1709)
- Hongxi Chen
Institutions
- Xiamen University (CN)
- Sichuan University (CN)
- West China Medical Center of Sichuan University (CN)
- Leshan Normal University (CN)
- First Affiliated Hospital of Xiamen University (CN)
- West China Hospital of Sichuan University (CN)
- Zhongshan Hospital of Xiamen University (CN)
- Chongqing Three Gorges Central Hospital (CN)
- Chengdu Second People's Hospital (CN)
- Chongqing Three Gorges University (CN)
Publication Details
- Journal
- Clinical and Translational Gastroenterology
- Published
- 2026-09-18
- DOI
- https://doi.org/10.14309/ctg.0000000000001096
- Primary Topic
- Liver Disease and Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00