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Risk assessment of development of hepatic decompensation in histologically proven hepatitis B viral cirrhosis using liver stiffness measurement.

Authors
 Kim B.K.  ;  Park Y.N.  ;  Kim D.Y.  ;  Park J.Y.  ;  Chon C.Y.  ;  Han K.-H.  ;  Ahn S.H. 
Citation
 Digestion, Vol.85(3) : 219-227, 2012 
Journal Title
 Digestion 
ISSN
 0012-2823 
Issue Date
2012
MeSH
Ascites/etiology ; Ascites/pathology ; Elasticity Imaging Techniques/methods* ; Esophageal and Gastric Varices/etiology ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/pathology ; Hepatic Encephalopathy/etiology ; Hepatic Encephalopathy/pathology ; Hepatic Insufficiency/etiology* ; Hepatic Insufficiency/pathology ; Hepatitis B, Chronic/complications* ; Hepatitis B, Chronic/diagnosis ; Humans ; Liver Cirrhosis/complications* ; Liver Cirrhosis/diagnosis ; Longitudinal Studies ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Risk Assessment
Keywords
Chronic hepatitis B ; Decompensation ; Liver cirrhosis ; Liver stiffness measurement ; Prediction
Abstract
BACKGROUND/AIMS: There are few studies regarding the predictive value of liver stiffness measurement (LSM) for development of hepatic decompensation. We assessed the risk of hepatic decompensations in B-viral compensated cirrhosis, using an LSM and LSM-based model (LSM-spleen diameter to platelet ratio score, LSPS = LSM × spleen diameter/platelet count) in a prospective, longitudinal study. METHODS: We analyzed 217 patients with histologically proven B-viral cirrhosis, well-preserved liver function, and no history of decompensation. The Kaplan-Meier and Cox regression method were used to examine the major endpoint, time to the first decompensation event, defined as development of ascites, hepatic encephalopathy, variceal hemorrhage, and deterioration of liver function to Child-Pugh class B/C. RESULTS: During follow-up, 26 patients experienced hepatic decompensation, ascites (n = 22), hepatic encephalopathy (n = 11), variceal hemorrhage (n = 9), and deterioration of liver function (n = 20). For risk stratification, patients were grouped as LSM <13, 13-18, and ≥18 kPa, and from multivariate analysis, patients with LSM 13-18 kPa [hazard ratio (HR) 4.547/ p = 0.044] and ≥18 kPa (HR 12.446/p < 0.001) retained independently higher risks than patients with LSM <13 kPa. Similarly, when patients were grouped as LSPS <1.1, 1.1-2.5, and ≥2.5, those with LSPS 1.1-2.5 (HR 5.796/p = 0.004) and ≥2.5 (HR 13.618/p < 0.001) retained independently higher risks than those with LSPS <1.1. CONCLUSION: LSM and LSPS are useful in risk assessment of hepatic decompensation among complication-naive B-viral cirrhotic patients.
Full Text
http://www.karger.com/Article/FullText/335430
DOI
22414567
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
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
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
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
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90134
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