Simple non‐invasive scoring systems and histological scores in predicting mortality in patients with non‐alcoholic fatty liver disease: A systematic review and meta‐analysis

作者：Chang‐Hai Liu, Javier Ampuero, Michael Pavlides, Vincent Wai‐Sun Wong, Jian‐Gao Fan, Lang Bai, Hong Li, Dong‐Bo Wu, Lingyun Zhou, Lingyao Du, Tian‐Kuo Yang, Wei Jiang, Ying Shi, Antonio Gil‐Gómez, Wenting Zhang, Jiaxu Liang, Manuel Romero‐Gómez, Hong Tang · 发表于：Journal of Gastroenterology and Hepatology · 年份：2021 · DOI：10.1111/jgh.15431 · 被引用次数：7 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Hepatocellular Carcinoma Treatment and Prognosis

BACKGROUND AND AIM: There is debate among the hepatology community regarding the simple non-invasive scoring systems and histological scores (even it was developed for histological classification) in predicting clinical outcomes in patients with non-alcoholic fatty liver disease (NAFLD). This study aimed to determine whether the presence of simple non-invasive scoring systems and histological scores could predict all-cause mortality, liver-related mortality, and liver disease decompensation (liver failure, cirrhosis, hepatocellular carcinoma, or decompensated liver disease). METHODS: The pooled hazard ratio of prognostic factors and incidence rate per 1000 person-years in patients with NAFLD was calculated and further adjusted by two different models of handling the duplicated data. RESULTS: A total of 19 longitudinal studies were included. Most simple non-invasive scoring systems (Fibrosis-4 Score, BARD, and aspartate aminotransferase-to-platelet ratio index ) and histological scores (NAFLD activity score, Brunt, and "steatosis, activity, and fibrosis" ) failed in predicting mortality, and only the NAFLD fibrosis score > 0.676 showed prognostic ability to all-cause mortality (four studies, 7564 patients, 118 352 person-years followed up, pooled hazard ratio 1.44, 95% confidence interval [CI] 1.05-1.96). The incidence rate per 1000 person-years of all-cause mortality, liver-related mortality, cardiovascular-related mortality, and liver disease decompensation resulted in a poo...