{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:34:20Z","timestamp":1792611260854,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) improves survival in patients with cirrhosis with refractory ascites and portal hypertensive bleeding. However, the indication for TIPS in older adult patients (greater than or equal to 70\u2009years) is debated, and a specific prediction model developed in this particular setting is lacking. The aim of this study was to develop and validate a multivariable model for an accurate prediction of mortality in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results:<\/jats:title>\n                    <jats:p>We prospectively enrolled 411 consecutive patients observed at four referral centers with de novo TIPS implantation for refractory ascites or secondary prophylaxis of variceal bleeding (derivation cohort) and an external cohort of 415 patients with similar indications for TIPS (validation cohort). Older adult patients in the two cohorts were 99 and 76, respectively. A cause\u2010specific Cox competing risks model was used to predict liver\u2010related mortality, with orthotopic liver transplant and death for extrahepatic causes as competing events. Age, alcoholic etiology, creatinine levels, and international normalized ratio in the overall cohort, and creatinine and sodium levels in older adults were independent risk factors for liver\u2010related death by multivariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>After TIPS implantation, mortality is increased by aging, but TIPS placement should not be precluded in patients older than 70\u2009years. In older adults, creatinine and sodium levels are useful predictors for decision making. Further efforts to update the prediction model with larger sample size are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.32704","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T14:13:30Z","timestamp":1659536010000},"page":"476-488","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":54,"title":["Mortality after transjugular intrahepatic portosystemic shunt in older adult patients with cirrhosis: A validated prediction model"],"prefix":"10.1097","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3014-8968","authenticated-orcid":false,"given":"Francesco","family":"Vizzutti","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5662-2162","authenticated-orcid":false,"given":"Ciro","family":"Celsa","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, Gastroenterology and Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy"},{"name":"Department of Surgical, Oncological, and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0287-1059","authenticated-orcid":false,"given":"Vincenza","family":"Calvaruso","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, Gastroenterology and Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Enea","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, Gastroenterology and Hepatology Unit, University of Palermo, Palermo, Sicilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Department of Economics, Business, and Statistics (SEAS), University of Palermo, Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Turco","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Modena Hospital, University of Modena and Reggio Emilia, Modena, Italy"},{"name":"Internal Medicine Unit for the Treatment of Severe Organ Failure, Dipartimento medico chirurgico delle malattie digestive, epatiche ed endocrino\u2010metaboliche, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero\u2010Universitaria di Bologna, Policlinico di Sant'Orsola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Senzolo","sequence":"additional","affiliation":[{"name":"Multivisceral Transplant Unit\u2010Gastroenterology, Department of Surgery, Oncology, and Gastroenterology, Padua University Hospital, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7038-9539","authenticated-orcid":false,"given":"Silvia","family":"Nardelli","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Miraglia","sequence":"additional","affiliation":[{"name":"Radiology Unit, Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced 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Bonaventura","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Citone","sequence":"additional","affiliation":[{"name":"Department of Radiology, Interventional Radiology Unit, Careggi Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Guasconi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Modena Hospital, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Di Benedetto","sequence":"additional","affiliation":[{"name":"Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Arena","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Fanelli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Interventional Radiology Unit, Careggi Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Maruzzelli","sequence":"additional","affiliation":[{"name":"Radiology Unit, Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliviero","family":"Riggio","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Burra","sequence":"additional","affiliation":[{"name":"Multivisceral Transplant Unit\u2010Gastroenterology, Department of Surgery, Oncology, and Gastroenterology, Padua University Hospital, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Modena Hospital, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-7022","authenticated-orcid":false,"given":"Erica","family":"Villa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Modena Hospital, University of Modena and Reggio Emilia, Modena, 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