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off the press, we will be discussing @HEP_Journal article "Risk prediction model for post-op mortality in cirrhosis"http://www.vocalpennscore.com/
Moderator: @AtoosaRabiee
Experts: @nadimmahmud @serperm
Dont miss this!!
https://doi.org/10.1002/hep.31558
#Livertwitter #GIJC #GIfellows
Article Summary published in @HEP_Journal
Novel Risk Prediction Models for Post-Operative Mortality in Patients with Cirrhosis
https://doi.org/10.1002/hep.31558
@atoosa @RhubbBstat @serperm @nadimmahmud @DrLiver @KaplanDeLiver
Novel Risk Prediction Models for Post-Operative Mortality in Patients with Cirrhosis
https://doi.org/10.1002/hep.31558
@atoosa @RhubbBstat @serperm @nadimmahmud @DrLiver @KaplanDeLiver
1/6
Background:
Pts w/ cirrhosis
risk of post-op
Currently available
to predict post-op risk are suboptimal, dont account for surgery type #GIJC
Aim:
Use population-level data to derive and internally validate novel cirrhosis surgical risk models #GIJC
Background: Pts w/ cirrhosis
risk of post-opCurrently available
to predict post-op risk are suboptimal, dont account for surgery type #GIJCAim:Use population-level data to derive and internally validate novel cirrhosis surgical risk models #GIJC
Methods- Retrosp cohort study using data from VOCAL (128 US
merged with VASQIP) to identify 
procedures. - Multivariable logistic regression to model 30, 90, and 180-day post-op
- VOCAL-Penn compared to MRS, MELD,
MELD-Na & CTP scores. #GIJC
3/6
Results
- 4,712 surgical procedures in 3,785 pts w/ cirrhosis
atients with cirrhosis.
- VOCALPenn models were derived and internally validated with
discrimination (30-day postoperative mortality C-statistic=0.859).
Results- 4,712 surgical procedures in 3,785 pts w/ cirrhosis
atients with cirrhosis.
- VOCALPenn models were derived and internally validated with
discrimination (30-day postoperative mortality C-statistic=0.859).
5/6
Conclusion
- VOCAL-Penn models substantially improve post-operative mortality predictions in pts with cirrhosis.
- Use in clinical prac for pre-operative risk stratification and optimize patient selection ( http://www.vocalpennscore.com )
#GIJC
Conclusion- VOCAL-Penn models substantially improve post-operative mortality predictions in pts with cirrhosis.
- Use in clinical prac for pre-operative risk stratification and optimize patient selection ( http://www.vocalpennscore.com )
#GIJC
5/6- Predictors included age, pre-op alb, plt, bili, Sx type, rubin, emergency, fatty liver, ASA, obesity
-Model performance was sup to MELD, MELD-Na, CTP, and MRS in terms of discrimination and calibration #gijc
-Model performance was sup to MELD, MELD-Na, CTP, and MRS in terms of discrimination and calibration #gijc
6/6
Limitations
- Data set largely
w/ psychosocial issues
- Do not address modifiable risk factors pre-op TIPS or BB
- Because of nature of study, pts who didn’t receive surgery were not included (skewed towards low risk pts)
- No external validation #GIJC
Limitations- Data set largely
w/ psychosocial issues- Do not address modifiable risk factors pre-op TIPS or BB
- Because of nature of study, pts who didn’t receive surgery were not included (skewed towards low risk pts)
- No external validation #GIJC
