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Validation of a model for identification of patients with compensated cirrhosis at high risk of decompensation

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العنوان: Validation of a model for identification of patients with compensated cirrhosis at high risk of decompensation
المؤلفون: Rebecca Harris, Audrey Dillon, Imad Waked, Philip J. Johnson, David J. Harman, Stephen Stewart, Alessandro Cucchetti, Sarah Berhane, Guruprasad P. Aithal, Omar Elshaarawy, Lisa Coffey, Indra Neil Guha, Martin W. James
المساهمون: Guha I.N., Harris R., Berhane S., Dillon A., Coffey L., James M.W., Cucchetti A., Harman D.J., Aithal G.P., Elshaarawy O., Waked I., Stewart S., Johnson P.J.
المصدر: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
بيانات النشر: Elsevier, 2019.
سنة النشر: 2019
مصطلحات موضوعية: Liver Cirrhosis, Alcohol-Associated Liver Disease Outcome, Male, medicine.medical_specialty, Cirrhosis, Prognosi, Liver Cirrhosi, liver failure, prognostic factor, alcohol-associated liver disease outcome, NAFLD prediction, Predictive Value of Test, Risk Assessment, Severity of Illness Index, Follow-Up Studie, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Model for End-Stage Liver Disease, Predictive Value of Tests, Risk Factors, Internal medicine, medicine, Humans, Decompensation, Prospective Studies, NAFLD Prediction, Aged, Framingham Risk Score, Hepatology, business.industry, Prognostic Factor, Risk Factor, Hazard ratio, Gastroenterology, Middle Aged, Prognosis, medicine.disease, Prospective Studie, Liver, 030220 oncology & carcinogenesis, Cohort, Disease Progression, Egypt, Female, 030211 gastroenterology & hepatology, Liver function, business, Ireland, Liver Failure, Follow-Up Studies, Human
الوصف: Background & Aims It is important to rapidly identify patients with advanced liver disease. Routine tests to assess liver function and fibrosis provide data that can be used to determine patients’ prognoses. We tested the validated the ability of combined data from the ALBI and FIB-4 scoring systems to identify patients with compensated cirrhosis at highest risk for decompensation. Methods We collected data from 145 patients with compensated cirrhosis (91% Child A cirrhosis and median MELD scores below 8) from a cohort in Nottingham, United Kingdom, followed for a median 4.59 years (development cohort). We collected baseline clinical features and recorded decompensation events. We used these data to develop a model based on liver function (assessed by the ALBI score) and extent of fibrosis (assessed by the FIB-4 index) to determine risk of decompensation. We validated the model in 2 independent external cohorts (1 in Dublin, Ireland and 1 in Menoufia, Egypt) comprising 234 patients. Results In the development cohort, 19.3% of the patients developed decompensated cirrhosis. Using a combination of ALBI and FIB-4 scores, we developed a model that identified patients at low vs high risk of decompensation (hazard ratio [HR] for decompensation in patients with high risk score was 7.10). When we tested the scoring system in the validation cohorts, the HR for decompensation in patients with a high-risk score was 12.54 in the Ireland cohort and 5.10 in the Egypt cohort. Conclusion We developed scoring system, based on a combination of ALBI and FIB-4 scores, that identifies patients at risk for liver decompensation. We validated the scoring system in 2 independent international cohorts (Europe and the Middle East), so it appears to apply to diverse populations.
وصف الملف: PDF; application/pdf; STAMPA
اللغة: English
تدمد: 1542-3565
1542-7714
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::737d54f993efc2f92be24a5e3df25320
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....737d54f993efc2f92be24a5e3df25320
قاعدة البيانات: OpenAIRE
الوصف
تدمد:15423565
15427714