TY - JOUR
T1 - A Novel SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102)
T2 - An International Multicenter Cohort Study
AU - Liu, Chuan
AU - Cao, Zhujun
AU - Yan, Huadong
AU - Wong, Yu Jun
AU - Xie, Qing
AU - Hirooka, Masashi
AU - Enomoto, Hirayuki
AU - Kim, Tae Hyung
AU - Hanafy, Amr Shaaban
AU - Liu, Yanna
AU - Huang, Yifei
AU - Li, Xiaoguo
AU - Kang, Ning
AU - Koizumi, Yohei
AU - Hiasa, Yoichi
AU - Nishimura, Takashi
AU - Iijima, Hiroko
AU - Jung, Young Kul
AU - Yim, Hyung Joon
AU - Guo, Ying
AU - Zhang, Linpeng
AU - Ma, Jianzhong
AU - Kumar, Manoj
AU - Jindal, Ankur
AU - Teh, Kok Ban
AU - Sarin, Shiv Kumar
AU - Qi, Xiaolong
N1 - Publisher Copyright:
© 2022 Wolters Kluwer Health. All rights reserved.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - INTRODUCTION: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.METHODS: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).RESULTS: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).DISCUSSION:The SAVE score can be readily incorporated into clinical practice to accurately predict the individual risk of hepatic decompensation in cACLD.
AB - INTRODUCTION: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.METHODS: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).RESULTS: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).DISCUSSION:The SAVE score can be readily incorporated into clinical practice to accurately predict the individual risk of hepatic decompensation in cACLD.
UR - https://www.scopus.com/pages/publications/85139573104
U2 - 10.14309/ajg.0000000000001873
DO - 10.14309/ajg.0000000000001873
M3 - Article
C2 - 35973168
AN - SCOPUS:85139573104
SN - 0002-9270
VL - 117
SP - 1605
EP - 1613
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 10
ER -