Validation of non-invasive diagnosis of CSPH in patients with compensated advanced chronic liver disease according to Baveno VII.
Liver Int
; 43(9): 1966-1974, 2023 09.
Article
em En
| MEDLINE
| ID: mdl-37288716
ABSTRACT
BACKGROUND AND AIMS:
Baveno VII consensus introduced the non-invasive criteria of clinically significant portal hypertension (CSPH) using liver stiffness measurement (LSM). We evaluated the usefulness of the Baveno VII criteria to predict the risk of decompensation in patients with compensated advanced chronic liver disease (cACLD).METHODS:
We conducted a retrospective cohort study of 1966 patients with cACLD. Patients were categorized into four groups (CSPH excluded (n = 619), grey zone (low risk of CSPH (n = 699), high risk of CSPH (n = 207)), and CSPH included (n = 441)) according to Baveno VII consensus. The risk of events was estimated using a Fine and Gray competing risk regression analysis, with liver transplantation and death as competing events. We calculated standardized hazard ratios (sHR) to assess the relative risk of decompensation.RESULTS:
Among 1966 patients, 178 developed decompensations over a median follow-up of 3.06 (IQR 1.03-6.00) years. Patients with CSPH had the highest decompensation risk, followed by the grey zone high-risk group, grey zone low-risk group, and those without CSPH with 3-year cumulative risks of 22%, 12%, 3.3%, and 1.4% respectively (p < .001). Compared to CSPH excluded group, CSPH included group (sHR 8.00, 95% CI 4.00-16.0), grey zone high-risk group (sHR 6.57, 95% CI 3.16-13.6), grey zone low-risk group (sHR 2.15, 95% CI 1.04-4.41) had significantly higher risk of decompensation (Gray's test p < .01).CONCLUSION:
Non-invasive diagnosis of CSPH according to the Baveno VII criteria can stratify the risk of decompensation.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Varizes Esofágicas e Gástricas
/
Técnicas de Imagem por Elasticidade
/
Hipertensão Portal
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article