Publication Name	World Journal of Gastroenterology
Manuscript ID	123607
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Cohort Study
Article Title	Assessed spontaneous portosystemic shunts to better predict overt hepatic encephalopathy before transjugular intrahepatic portosystemic shunt: A multicenter study
Manuscript Source	Unsolicited Manuscript
All Author List	Xiao-Qiong Chen, Liu-Jia Mao, Xiang-Rong Yu, Tian-Quan Ouyang, Wei-Guo Xu, Jun-Yang Luo, Wei Han, Xiang Yang, Jia-Rui Chen, Chong-Yang Duan and Si-Rui Fu
Funding Agency and Grant Number	Funding Agency Grant Number National Natural Science Foundation of China 62027901, 82272069 and 82273727 Guangdong Basic and Applied Basic Research Foundation 2024A1515012023 Clinical Research Promotion Project of Zhuhai People's Hospital 2023 LCTS-06 and 2023 LCTS-07
Corresponding Author	Si-Rui Fu, MD, PhD, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People’s Hospital (The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University), No. 79 Kangning Road, Zhuhai 519000, Guangdong Province, China. fusiruismu@sina.com
Key Words	Spontaneous portosystemic shunt; Transjugular intrahepatic portosystemic shunt; Overt hepatic encephalopathy; Hepatic-associated vascular factor; Predict; Subgroup
Core Tip	Overt hepatic encephalopathy (HE) precluded the application of transjugular intrahepatic portosystemic shunt, which is the only minimally invasive treatment having curative effect for portal hypertension related variceal bleeding and ascites. This multicenter study identified the optimized method among four spontaneous portosystemic shunt (SPSS) assessment approaches. Then we utilized SPSS to further improve the risk prediction of overt HE (training dataset: 0.844; external validation dataset: 0.820), outperforming the six existing models (Child-Pugh; model for end-stage liver disease; transverse psoas muscle thickness and psoas muscle attenuation; albumin; AMMON-overt hepatic encephalopathy; and Lambda) by 13%-50%. Our established pipeline might provide additional insight for studies predicting risks of cirrhosis related events.
Citation	Chen XQ, Mao LJ, Yu XR, Ouyang TQ, Xu WG, Luo JY, Han W, Yang X, Chen JR, Duan CY, Fu SR. Assessed spontaneous portosystemic shunts to better predict overt hepatic encephalopathy before transjugular intrahepatic portosystemic shunt: A multicenter study. World J Gastroenterol 2026; In press

Received	2026-05-27 06:48
Peer-Review Started	2026-05-27 06:48
First Decision by Editorial Office Director
Return for Revision	2026-07-27 03:34
Revised	2026-08-05 02:27
Publication Fee Transferred	2026-08-14 00:36
Second Decision by Editor	2026-09-21 02:40
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-09-21 09:36
Articles in Press	2026-09-21 09:36
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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