A Novel Score for Predicting Long‐Term Outcomes in Recanalisation‐Treated Patients With Budd‐Chiari Syndrome: A Multicentre Study

作者：Dongdong Xia, Bohan Luo, Qiuhe Wang, Chunqing Zhang, Kewei Zhang, Mingxing Li, Qingyong Fan, Qi Wang, Wei Bai, Kai Li, Wengang Guo, Jiahao Fan, Guangchuan Wang, Aiyuan Xiu, Zheng‐Yu Wang, Jie Yuan, Yong Lv, Menghao Li, B. Li, Zenghui Dong, Na Zhang, Yiwei Shang, Wei Dai, Yalan Wang, Hong Tang, Zhanxin Yin, Yan Zhao, Jielai Xia, Daiming Fan, Ke Xu, Kaichun Wu, Guohong Han · 发表于：Liver International · 年份：2025 · DOI：10.1111/liv.70259 · 被引用次数：3 · 研究领域：Liver Disease and Transplantation、Organ Transplantation Techniques and Outcomes、Liver Diseases and Immunity

BACKGROUND AND AIMS: A recanalisation-specific model for Budd-Chiari syndrome (BCS) is lacking. We aimed to develop a novel score for individual long-term outcome prediction and risk stratification. METHODS: Overall, 834 BCS patients undergoing recanalisation (566 received percutaneous transluminal angioplasty alone, and 268 with routine stenting) from January 2010 to May 2019 were included from six Chinese centres. The model was developed using Cox multivariable regression, internally validated through a 1000-times bootstrapped method, and compared its performance with existing BCS prognostic models, like the Clichy score. RESULTS: During the median follow-up period of 58.0 months, 44 patients were converted to transjugular intrahepatic portosystemic shunt (TIPS), none underwent orthotopic liver transplantation (OLT) and 75 died. The final BCS-Recanalisation score incorporated: variceal bleeding history, degree of ascites, albumin, creatinine, urea, white blood cell count and Ln (alkaline phosphatase). The score outperformed other available models with good discrimination (C-index: 0.74) and calibration in predicting TIPS-free survival in the whole cohort, internal validation and most subgroups. Moreover, patients were categorised as low-risk (BCS-Recanalisation score ≤ 2.0), intermediate-risk (2.0-2.6) and high-risk (> 2.6) groups using X-tile software, with a 5-year TIPS-free survival rate of 92.2% (95% CI: 89.5%-95.0%), 84.7% (95% CI: 80.0%-90.0%) and 67.8% (95% CI: 59.4%...