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Noninvasive risk assessment of hepatic decompensation in patients with hepatitis B virus-related liver cirrhosis

Authors
 David Sooik Kim  ;  Beom Kyung Kim  ;  Jae Seung Lee  ;  Hye Won Lee  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Nikolaos Pyrsopoulos  ;  Seung Up Kim 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.38(8) : 1372-1380, 2023-08 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2023-08
MeSH
Albumins ; Bilirubin ; Fibrosis ; Hepatitis B virus ; Humans ; Hypertension, Portal* / complications ; Liver Cirrhosis ; Prognosis ; Retrospective Studies ; Risk Assessment ; Varicose Veins* / complications
Keywords
cirrhosis ; hepatic decompensation ; prediction ; prognosis ; risk
Abstract
Background and aim: Hepatic decompensation is a major complication of liver cirrhosis. We validated the predictive performance of the newly proposed CHESS-ALARM model to predict hepatic decompensation in patients with hepatitis B virus (HBV)-related cirrhosis and compared it with other transient elastography (TE)-based models such as liver stiffness-spleen size-to-platelet (LSPS), portal hypertension (PH), varices risk scores, albumin-bilirubin (ALBI), and albumin-bilirubin-fibrosis-4 (ALBI-FIB-4).

Methods: Four hundred eighty-two patients with HBV-related liver cirrhosis between 2006 and 2014 were recruited. Liver cirrhosis was clinically or morphologically defined. The predictive performance of the models was assessed using a time-dependent area under the curve (tAUC).

Results: During the study period, 48 patients (10.0%) developed hepatic decompensation (median 93 months). The 1-year predictive performance of the LSPS model (tAUC = 0.8405) was higher than those of the PH model (tAUC = 0.8255), ALBI-FIB-4 (tAUC = 0.8168), ALBI (tAUC = 0.8153), CHESS-ALARM (tAUC = 0.8090), and variceal risk score (tAUC = 0.7990). The 3-year predictive performance of the LSPS model (tAUC = 0.8673) was higher than those of the PH risk score (tAUC = 0.8670), CHESS-ALARM (tAUC = 0.8329), variceal risk score (tAUC = 0.8290), ALBI-FIB-4 (tAUC = 0.7730), and ALBI (tAUC = 0.7451). The 5-year predictive performance of the PH risk score (tAUC = 0.8521) was higher than those of the LSPS (tAUC = 0.8465), varices risk score (tAUC = 0.8261), CHESS-ALARM (tAUC = 0.7971), ALBI-FIB-4 (tAUC = 0.7743), and ALBI (tAUC = 0.7541). However, there was no significant difference in the predictive performance among all models at 1, 3, and 5 years (P > 0.05).

Conclusions: The CHESS-ALARM score was able to reliably predict hepatic decompensation in patients with HBV-related liver cirrhosis and showed similar performance to the LSPS, PH, varices risk scores, ALBI, and ALBI-FIB-4.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/jgh.16210
DOI
10.1111/jgh.16210
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jae Seung(이재승) ORCID logo https://orcid.org/0000-0002-2371-0967
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196721
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