{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:08:59Z","timestamp":1790104139052,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mortality following transjugular intrahepatic portosystemic shunt (TIPS) placement remains a critical concern. Traditional scoring systems, such as the Model for End\u2010Stage Liver Disease (MELD) and MELD\u2010Na, as well as the newer Modified TIPS\u2010Score (MOTS) and Freiburg Index of Post\u2010TIPS Survival (FIPS), have shown potential for refining risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To externally validate prognostic scores for predicting 30\u2010 and 90\u2010day mortality following TIPS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study, conducted at Austin Health, Australia, included 117 patients who underwent TIPS with \u226590\u2009days of follow\u2010up between 2011 and 2024. Prognostic scores were calculated using pre\u2010TIPS clinical and laboratory data. Discrimination and calibration were assessed and prognostic accuracy evaluated at established thresholds for MELD \u2265 18, MELD\u2010Na \u2265 20, MOTS &gt; 1, FIPS \u2265 0.92 and additional scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TIPS indications included ascites and\/or hepatic hydrothorax (56.4%), variceal haemorrhage (34.2%), Budd\u2010Chiari syndrome (6.0%) and other indications (3.4%). Mortality occurred in 13 (11.1%) and 21 patients (17.9%) by 30 and 90 days respectively. MELD demonstrated the best discrimination for 30\u2010day mortality (area under the curve (AUC)\u2009=\u20090.82), followed by MOTS (0.80), FIPS (0.76) and MELD\u2010Na (0.73), with similar trends at 90\u2009days. MOTS was best calibrated, followed by FIPS and MELD. FIPS \u2265 0.92 had excellent specificities (94% and 95%) and negative predictive values (94% and 88%) for 30\u2010 and 90\u2010day mortality, marginally outperforming MELD and MOTS. MELD\u2010Na and other scores performed less well.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MOTS, MELD and FIPS demonstrated robust discriminative performance for early post\u2010TIPS mortality and outperformed other models. Further research is required to establish optimum risk thresholds for these tools and support these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70373","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:28:36Z","timestamp":1773005316000},"page":"552-562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic scores for early mortality following transjugular intrahepatic portosystemic shunt insertion: external validation in a contemporary Australian cohort"],"prefix":"10.1111","volume":"56","author":[{"given":"Nirbaanjot","family":"Walia","sequence":"first","affiliation":[{"name":"Gastroenterology and Liver Transplant Unit Austin Health  Heidelberg Victoria Australia"},{"name":"Biostatistics Unit, Melbourne School of Population and Global Health The University of Melbourne  Melbourne Victoria 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