TY  - JOUR
A1  - Trebicka, Jonel
A1  - Gu, Wenyi
A1  - de Ledinghen, Victor
A1  - Aubé, Christophe
A1  - Krag, Aleksander
A1  - Praktiknjo, Michael
A1  - Castera, Laurent
A1  - Dumortier, Jerome
A1  - Bauer, David Josef Maria
A1  - Friedrich-Rust, Mireen
A1  - Pol, Stanislas
A1  - Grgurevic, Ivica
A1  - Zheng, Rongqin
A1  - Francque, Sven
A1  - Gottfriedovà, Halima
A1  - Mustapic, Sanda
A1  - Sporea, Ioan
A1  - Berzigotti, Annalisa
A1  - Uschner, Frank Erhard
A1  - Simbrunner, Benedikt Michael
A1  - Ronot, Maxime
A1  - Cassinotto, Christophe
A1  - Kjaergaard, Maria
A1  - Andrade, Filipe
A1  - Schulz, Martin
A1  - Semmler, Georg
A1  - Drinkovic, Ida Tjesic
A1  - Chang, Johannes
A1  - Brol, Maximilian
A1  - Rautou, Pierre Emmanuel
A1  - Vanwolleghem, Thomas
A1  - Straßburg, Christian P.
A1  - Boursier, Jerome
A1  - Ferstl, Philip
A1  - Rasmussen, Ditlev Nytoft
A1  - Reiberger, Thomas
A1  - Vilgrain, Valerie
A1  - Guibal, Aymeric
A1  - Guillaud, Olivier
A1  - Zeuzem, Stefan
A1  - Vassord, Camille
A1  - Lu, Xue
A1  - Vonghia, Luisa
A1  - Senkerikova, Renata
A1  - Popescu, Alina
A1  - Margini, Cristina
A1  - Wang, Wenping
A1  - Thiele, Maja
A1  - Jansen, Chrisitan
T1  - Two-dimensional shear wave elastography predicts survival in advanced chronic liver disease
T2  - Gut
N2  - Objective

Liver stiffness measurement (LSM) is a tool used to screen for significant fibrosis and portal hypertension. The aim of this retrospective multicentre study was to develop an easy tool using LSM for clinical outcomes in advanced chronic liver disease (ACLD) patients.

Design

This international multicentre cohort study included a derivation ACLD patient cohort with valid two-dimensional shear wave elastography (2D-SWE) results. Clinical and laboratory parameters at baseline and during follow-up were recorded. LSM by transient elastography (TE) was also recorded if available. The primary outcome was overall mortality. The secondary outcome was the development of first/further decompensation.

Results

After screening 2148 patients (16 centres), 1827 patients (55 years, 62.4% men) were included in the 2D-SWE cohort, with median liver SWE (L-SWE) 11.8 kPa and a model for end stage liver disease (MELD) score of 8. Combination of MELD score and L-SWE predict independently of mortality (AUC 0.8). L-SWE cut-off at ≥20 kPa combined with MELD ≥10 could stratify the risk of mortality and first/further decompensation in ACLD patients. The 2-year mortality and decompensation rates were 36.9% and 61.8%, respectively, in the 305 (18.3%) high-risk patients (with L-SWE ≥20 kPa and MELD ≥10), while in the 944 (56.6%) low-risk patients, these were 1.1% and 3.5%, respectively. Importantly, this M10LS20 algorithm was validated by TE-based LSM and in an additional cohort of 119 patients with valid point shear SWE-LSM.

Conclusion

The M10LS20 algorithm allows risk stratification of patients with ACLD. Patients with L-SWE ≥20 kPa and MELD ≥10 should be followed closely and receive intensified care, while patients with low risk may be managed at longer intervals.
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/86008
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-860081
SN  - 1468-3288
N1  - JT is supported by grants from the Deutsche Forschungsgemeinschaft (SFB TRR57 to P18), European Union’s Horizon 2020 Research and Innovation Programme (Galaxy, No. 668031, MICROB-PREDICT, No. 825694 and DECISION No.84794), and Societal Challenges - Health, Demographic Change and Wellbeing (No. 731875), and Cellex Foundation (PREDICT). WG is supported by the China Scholarships Council (CSC: #201906230332). SF has a senior clinical research mandate from the Fund for Scientific Research (FWO) Flanders (1802154N). RZ was supported by the National Natural Science Foundation of China under grant no. 81827802.
VL  - 71
IS  - 2
SP  - 402
EP  - 414
PB  - BMJ Publishing Group
CY  - London
ER  -