Diagnostic and prognostic performance of the LiverRisk score in tertiary care

作者：Georg Semmler, Lorenz Balcar, Benedikt Simbrunner, Lukas Hartl, Mathias Jachs, Michael Schwarz, Benedikt Hofer, L. Fritz, Anna Schedlbauer, K Stopfer, Daniela Neumayer, Jurij Maurer, Sophie Gensluckner, B Scheiner, Elmar Aigner, Michael Trauner, Thomas Reiberger, Mattias Mandorfer · 发表于：JHEP Reports · 年份：2024 · DOI：10.1016/j.jhepr.2024.101169 · 被引用次数：4 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Inflammatory Biomarkers in Disease Prognosis

Background & Aims The LiverRisk score has been proposed as blood-based tool to estimate liver stiffness measurement (LSM), thereby stratifying the risk of compensated advanced chronic liver disease (cACLD, LSM≥10kPa) and liver-related events in subjects without known chronic liver disease (CLD). We aimed to evaluate its diagnostic/prognostic performance in tertiary care. Methods Subjects referred to two hepatology outpatient clinics (cohort-I: n=5897; cohort-II: n=1558) were retrospectively included. Calibration/agreement of the LiverRisk score with LSM was assessed, and diagnostic accuracy for cACLD compared to FIB-4/APRI. The prediction of hepatic decompensation and utility of proposed cut-offs were evaluated. Results In cohort-I/II, mean age was 48.3/51.8years, 44.2%/44.7% were female, predominant etiologies were viral hepatitis (51.8%)/ metabolic dysfunction-associated steatotic liver disease (63.7%), median LSM was 6.9 [5.1-10.9]/ 5.8 [4.5-8.8]kPa, and 1690 (28.7%)/ 322 (20.7%) had cACLD. Despite a moderate correlation (Pearson's r: 0.325/0.422), the LiverRisk score systematically underestimated LSM ("bias": 2.93/1.80points/kPa lower) and range of agreement was wide, especially at higher values. The diagnostic accuracy of the LiverRisk score for cACLD (AUROC: 0.757/0.790) was comparable to FIB-4 (0.769/0.813) and APRI (0.747/0.765). The proposed cut-off of 10 points yielded an accuracy of 74.2%/81.2%, high specificity (91.9/93.4%), but low negative predictive value (76.6...