Association Between Modified Frailty Index (mFI-5) and Postoperative Outcomes of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedures

Tuesday, April 14, 2026

4:03 PM - 4:12 PM ET

Location: 701B

Presenting Author(s)

Esha Shah (she/her/hers)

Medical Student
Rutgers NJMS, New Jersey, United States

Author/Co-author(s)

OK

Olivia Kola, MS

Medical Student
Rutgers New Jersey Medical School, New York, United States
AN

Aarya Nehe, BS, None

Medical Student
Rutgers New Jersey Medical School, New Jersey, United States
RS

Rishi Shah, BS

Medical Student
New Jersey Medical School, New Jersey, United States
Abhishek Kumar, MD

Division Chief of Vascular and Interventional Radiology
Rutgers New Jersey Medical School, New York, United States
PS

Pratik A. Shukla, MD

Associate Professor of Interventional Radiology
Rutgers - New Jersey Medical School, New Jersey, United States

Purpose: Frailty is a syndrome that causes decreased physiological resistance to stressors, and it has been associated with lower tolerance for and worse outcomes following invasive surgical procedures, including TIPS {1}. The 5-item modified frailty index (mFI-5) is useful in quantifying patient frailty for perioperative risk stratification for procedures such as transarterial chemoembolization and hepatic ablation {2,3}. This study aims to evaluate the predictive value of mFI-5 score for clinical outcomes following TIPS procedures.

Materials and Methods: Records of patients who underwent TIPS procedures between April 1st, 2016 and August 30, 2024 at a large, academic urban medical center were retrospectively reviewed. The mFI-5 was calculated for each patient by assigning 1 point for each of the following comorbidities: diabetes mellitus, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and functionally dependent health status. The primary outcomes measured were hospital length of stay, complications, hepatic encephalopathy, and 30-day mortality. Bivariate analysis with Pearson correlation and binary logistic regression were used to determine association between the mFI-5 score and TIPS outcome measures.

Results: Of 161 patients included in analysis, most had an mFI-5 score of 0 (n=47, 29.2%), 1 (mild, n=48, 29.8%), or 2 (moderate, n=50, 31.1%). Sixteen patients (9.9%) scored 3+ on mFI, indicating severe frailty. mFI-5 score did not correlate with hospital length of stay (r=-0.032, p=0.669). Compared with non-frail patients, mild, moderate, and severe frailty showed no statistically significant differences in complications, hepatic encephalopathy, or 30-day mortality (all CIs crossing 1, p > 0.05).

Conclusion: While frailty is an important factor for perioperative risk stratification, this study suggests that the mFI-5 score does not strongly correlate with outcomes following TIPS procedures. However, multicenter patient database studies may further elucidate the relationship between mFI-5 and TIPS outcomes.