NAFLD cirrhosis: a predictive model of liver decompensation

Non-alcoholic fatty liver disease (NAFLD) has become the most frequently encountered chronic liver disease and is an increasingly important cause of liver cirrhosis as well as other adverse events. The authors of this article retrospectively developed and validated a model to predict hepatic decompensation in NAFLD patients with cirrhosis and compared...
PUBLISHED IN: Hepatology 2020

Commentary

Non-alcoholic fatty liver disease (NAFLD) has become the most frequently encountered chronic liver disease and is an increasingly important cause of liver cirrhosis as well as other adverse events. The authors of this article retrospectively developed and validated a model to predict hepatic decompensation in NAFLD patients with cirrhosis and compared this with currently available models. Baseline variables from an international cohort of 299 biopsy-proven NAFLD patients with compensated cirrhosis were examined to construct a model using competing risk multivariate regression and Akaike/Bayesian information criteria. Validation was performed in 244 biopsy-proven NAFLD cirrhosis patients from the United States. Prognostic accuracy was compared with the NAFLD Fibrosis score (NFS), FIB-4, MELD, Child-Turcotte-Pugh (CTP) and ALBI-FIB-4 score using time-dependent area under the curve (tAUC) analysis. During a median follow-up of 5.6 years (range 2.4-14.1) and 5.4 years (range 1.5-13.8), hepatic decompensation occurred in 81 and 132 patients in the derivation and validation cohorts respectively. In the derivation cohort, independent predictors of hepatic decompensation (AST/ALT ratio, Bilirubin, INR, type 2 Diabetes and Oesophageal varices) were combined into the “ABIDE” model.

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Dr. G. Bozet, MD

Articles: 174

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