A novel score predicts mortality after transjugular intrahepatic portosystemic shunt: MOTS ‐ Modified TIPS Score

Background and aims The high risk for severe shunting‐related post‐interventional complications demands a stringent selection of candidates for transjugular intrahepatic portosystemic shunt (TIPS). We aimed to develop a simple and reliable tool to accurately predict early post‐TIPS mortality. Methods 144 cases of TIPS implantation were retrospectively analysed. Using univariate and multivariate Cox regression analysis of factors predicting mortality within 90 days after TIPS, a score integrating urea, international normalized ratio (INR) and bilirubin was developed. The Modified TIPS‐Score (MOTS) ranges from 0 to 3 points: INR >1.6, urea >71 mg/dl and bilirubin >2.2 mg/dl account for one point each. Additionally, MOTS was tested in an external validation cohort (n = 187) and its performance was compared to existing models. Results Modified TIPS‐Score achieved a significant prognostic discrimination reflected by 90‐day mortality of 8% in patients with MOTS 0–1 and 60% in patients with MOTS 2–3 (p