https://abs.twimg.com/emoji/v2/... draggable="false" alt="♨️" title="Heiße Quellen" aria-label="Emoji: Heiße Quellen">off the press, we will be discussing @HEP_Journal article "Risk prediction model for post-op mortality in cirrhosis"

http://www.vocalpennscore.com/ 

Moderator:">https://www.vocalpennscore.com/">... @AtoosaRabiee
Experts: @nadimmahmud @serperm

Dont miss this!!

https://doi.org/10.1002/hep.31558

https://doi.org/10.1002/h... href="https://twtext.com//hashtag/Livertwitter"> #Livertwitter #GIJC #GIfellows

Novel Risk Prediction Models for Post‐Operative Mortality in Patients with Cirrhosis

Background & Aims Patients with cirrhosis are at increased risk of post‐operative mortality. Currently available tools to predict post‐operative risk are suboptimally calibrated and do not account...

http://www.vocalpennscore.com/

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

https://doi.org/10.1002/h... href="https://twitter.com/atoosa">@atoosa @RhubbBstat @serperm @nadimmahmud @DrLiver @KaplanDeLiver

Novel Risk Prediction Models for Post‐Operative Mortality in Patients with Cirrhosis

Background & Aims Patients with cirrhosis are at increased risk of post‐operative mortality. Currently available tools to predict post‐operative risk are suboptimally calibrated and do not account...

https://doi.org/10.1002/hep.31558

1/6
https://abs.twimg.com/emoji/v2/... draggable="false" alt="⭐️" title="Mittelgroßer Stern" aria-label="Emoji: Mittelgroßer Stern">Background:
Pts w/ cirrhosis https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Pfeil nach oben" aria-label="Emoji: Pfeil nach oben">risk of post-ophttps://abs.twimg.com/emoji/v2/... draggable="false" alt="☠️" title="Totenkopf" aria-label="Emoji: Totenkopf">
Currently available https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔧" title="Schraubenschlüssel" aria-label="Emoji: Schraubenschlüssel">to predict post-op risk are suboptimal, dont account for surgery type #GIJC

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⭐️" title="Mittelgroßer Stern" aria-label="Emoji: Mittelgroßer Stern">Aim:
Use population-level data to derive and internally validate novel cirrhosis surgical risk models #GIJC

https://abs.twimg.com/emoji/v2/... draggable="false" alt="⭐️" title="Mittelgroßer Stern" aria-label="Emoji: Mittelgroßer Stern">Methods
- Retrosp cohort study using data from VOCAL (128 US https://abs.twimg.com/emoji/v2/... draggable="false" alt="🏥" title="Krankenhaus" aria-label="Emoji: Krankenhaus"> merged with VASQIP) to identify https://abs.twimg.com/emoji/v2/... draggable="false" alt="🔪" title="Küchenmesser" aria-label="Emoji: Küchenmesser">procedures.
- Multivariable logistic regression to model 30, 90, and 180-day post-op https://abs.twimg.com/emoji/v2/... draggable="false" alt="☠️" title="Totenkopf" aria-label="Emoji: Totenkopf">
- VOCAL-Penn compared to MRS, MELD,
MELD-Na & CTP scores. #GIJC

3/6
https://abs.twimg.com/emoji/v2/... draggable="false" alt="⭐️" title="Mittelgroßer Stern" aria-label="Emoji: Mittelgroßer Stern">Results
- 4,712 surgical procedures in 3,785 pts w/ cirrhosis
atients with cirrhosis.
- VOCALPenn models were derived and internally validated with https://abs.twimg.com/emoji/v2/... draggable="false" alt="👌" title="Ok hand" aria-label="Emoji: Ok hand"> discrimination (30-day postoperative mortality C-statistic=0.859).

5/6
https://abs.twimg.com/emoji/v2/... draggable="false" alt="⭐️" title="Mittelgroßer Stern" aria-label="Emoji: Mittelgroßer Stern">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"> 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

6/6
https://abs.twimg.com/emoji/v2/... draggable="false" alt="⭐️" title="Mittelgroßer Stern" aria-label="Emoji: Mittelgroßer Stern">Limitations
- Data set largely https://abs.twimg.com/emoji/v2/... draggable="false" alt="♂️" title="Männliches Zeichen" aria-label="Emoji: Männliches Zeichen"> w/ https://abs.twimg.com/emoji/v2/... draggable="false" alt="⬆️" title="Pfeil nach oben" aria-label="Emoji: Pfeil nach oben">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