Transient elastography has been proposed as a tool to predict the risk of decompensation in patients with
chronic liver disease. We aimed to identify risk groups of
disease progression, using a combination of baseline
liver stiffness measurement (LSM) and its change over time (delta-LSM) in patients with compensated advanced
chronic liver disease (cACLD).
Methods
Ninety-four patients with baseline LSM ≥10 kPa, Child–Pugh score 5 and without previous decompensation were included. A second LSM was performed during follow-up and data on liver function and liver-related events were collected. The primary endpoint was a composite that included death, liver decompensation and impairment in at least 1 point in Child–Pugh score.
Results
After a median follow-up of 43.6 months, 15% of patients presented the primary endpoint. Multivariate analysis identified baseline LSM (OR 1.12, P = 0.002) and delta-LSM (OR 1.02, P = 0.048) as independent predictors of the primary endpoint. A high risk group represented by patients with baseline LSM ≥21 kPa and delta-LSM ≥10% (risk of progression 47.1%, 95% CI: 23–71%) was identified, while patients with LSM <21 kPa and delta-LSM <10% presented zero risk of progression (P = 0.03).
Conclusions
Simple classification rules using baseline LSM and delta-LSM identify cACLD patients at low or high risk of disease progression.
