A Standardized Assessment of Functional Disability Predicts 1-year Mortality in XXXX Undergoing Transjugular Intrahepatic Portosystemic Shunt for Refractory Ascites.

@entity1 @entity82 @entity734 @entity3851
GOALS: To determine the association between functional disability and mortality after transjugular intrahepatic portosystemic shunt (TIPS). BACKGROUND: TIPS is a common therapeutic procedure for cirrhotic @entity1 with refractory ascites. The conventional metric for periprocedure risk stratification is the @entity3851 ( @entity3851 ), which uses biochemical parameters to predict post-TIPS mortality. It does not account for functional disability. STUDY: This is a retrospective cohort study of 83 @entity1 admitted at an academic liver transplant center with @entity82 and refractory ascites for the purpose of TIPS placement. We assessed the association of @entity1 ' reported activities of daily living (ADL) on a scale of 1 to 21 before TIPS with a primary outcome of 1-year mortality. Multivariable regression to adjust for @entity3851 and @entity1 class was performed. RESULTS: A higher ADL score or functional independence, was associated with decreased 1-year mortality when modeled as both a continuous variable [odds ratio (OR), 0.80; 95% confidence interval (CI), 0.66-0.97; P=0.02) and a dichotomous variable (ADL 21 vs. <21; OR, 0.21; 95% CI, 0.05-0.70; P=0.01). After adjusting for @entity3851 and @entity1 class, functional independence was associated with decreased 1-year transplant-free mortality (OR, 0.22; 95% CI, 0.05-0.77; P=0.02). An ADL score consistent with @entity734 (<21) was significantly associated with a 3.40-day (95% CI, 1.76-5.04) longer hospital stay, adjusting for @entity3851 and @entity1 class (P<0.0001). CONCLUSIONS: Functional disability is a predictor of post-TIPS mortality and length of stay after controlling for @entity3851 .
