Evaluating the predictive performance of the elderly patient calculator TIPS score in a North American cohort

TIPS is an effective intervention for the treatment of portal hypertensive complications of cirrhosis, including refractory ascites and variceal bleeding. However, TIPS placement can precipitate HE and liver failure, requiring liver transplantation. Risk stratification before candidate selection is therefore critical to mitigate adverse outcomes. Models like the Model for End-Stage Liver Disease Sodium (MELD-Na) and the Freiburg index of post-TIPS survival (FIPS) have been proposed to estimate the risk of mortality post-TIPS.1,2 Vizzutti et al recently proposed 2 post-TIPS prediction tools for overall patients [(overall elderly patients calculator TIPS (ExPeCT)] and for patients ≥ 70 years of age (older adult ExPeCT), using an Italian cohort.3 Due to health differences between Americans and Europeans, it is unclear how well these models translate to North American patients.4 We aimed to evaluate the performance of these post-TIPS mortality prediction tools in a large North American cohort.