A Novel SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102): An International Multicenter Cohort Study

In patients with compensated advanced chronic liver disease (cACLD), the invasive measurement of hepatic venous pressure gradient is the best predictor of hepatic decompensation. This study aimed at developing an alternative risk prediction model to provide a decompensation risk assessment in cACLD....

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:The American journal of gastroenterology Ročník 117; číslo 10; s. 1605 - 1613
Hlavní autoři: Liu, Chuan, Cao, Zhujun, Yan, Huadong, Wong, Yu Jun, Xie, Qing, Hirooka, Masashi, Enomoto, Hirayuki, Kim, Tae Hyung, Hanafy, Amr Shaaban, Liu, Yanna, Huang, Yifei, Li, Xiaoguo, Kang, Ning, Koizumi, Yohei, Hiasa, Yoichi, Nishimura, Takashi, Iijima, Hiroko, Jung, Young Kul, Yim, Hyung Joon, Guo, Ying, Zhang, Linpeng, Ma, Jianzhong, Kumar, Manoj, Jindal, Ankur, Teh, Kok Ban, Sarin, Shiv Kumar, Qi, Xiaolong
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Wolters Kluwer 01.10.2022
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
Témata:
Accuracy
Albumins
Ascites
Cohort analysis
Cohort Studies
Elasticity Imaging Techniques
Endoscopy
Etiology
Gastroenterology
Hepatitis
Humans
Hypertension
Hypertension, Portal - etiology
Liver
Liver cancer
Liver Cirrhosis - complications
Liver diseases
Mortality
Patients
Predictive Value of Tests
Retrospective Studies
Risk factors
Statistical analysis
Surveillance
Variables
China
India
ISSN:0002-9270, 1572-0241, 1572-0241
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Popis
Shrnutí:In patients with compensated advanced chronic liver disease (cACLD), the invasive measurement of hepatic venous pressure gradient is the best predictor of hepatic decompensation. This study aimed at developing an alternative risk prediction model to provide a decompensation risk assessment in cACLD. Patients with cACLD were retrospectively included from 9 international centers within the Portal Hypertension Alliance in China (CHESS) network. Baseline variables from a Japanese cohort of 197 patients with cACLD were examined and fitted a Cox hazard regression model to develop a specific score for predicting hepatic decompensation. The novel score was validated in an external cohort (n = 770) from 5 centers in China, Singapore, Korea, and Egypt, and was further assessed for the ability of predicting clinically significant portal hypertension in a hepatic venous pressure gradient cohort (n = 285). In the derivation cohort, independent predictors of hepatic decompensation were identified including Stiffness of liver, Albumin, Varices, and platElets and fitted to develop the novel score, termed "SAVE" score. This score performed significantly better (all P < 0.05) than other assessed methods with a time-dependent receiver operating characteristic curve of 0.89 (95% confidence interval [CI]: 0.83-0.94) and 0.83 (95% CI: 0.73-0.92) in the derivation and validation cohorts, respectively. The decompensation risk was best stratified by the cutoff values at -6 and -4.5. The 5-year cumulative incidences of decompensation were 0%, 24.9%, and 69.0% in the low-risk, middle-risk, and high-risk groups, respectively ( P < 0.001). The SAVE score also accurately predicted clinically significant portal hypertension (AUC, 0.85 95% CI: 0.80-0.90). The SAVE score can be readily incorporated into clinical practice to accurately predict the individual risk of hepatic decompensation in cACLD.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:0002-9270
1572-0241
1572-0241
DOI:10.14309/ajg.0000000000001873