Noninvasive assessment of liver fibrosis for predicting acute-on-chronic liver failure in patients with chronic hepatitis B

Yang, Feifei; Liu, Yujuan; Zeng, Baimei; Chu, Jun; Hu, Han Hwa; Yang, Yanqing; Chen, Huan; Tian, Caiyun; Liu, Ying; Lin, Shen

doi:10.1007/s12072-020-10106-1

Cited by 8 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 Hyperglycaemia might increases risks of adverse outcome. APRI score was initially developed as a noninvasive model for fibrosis and cirrhosis diagnosis, 32,33 which has been shown to be useful for the assessment of advanced liver fibrosis in a variety of liver diseases, such as chronic viral hepatitis [33][34][35] and non-alcoholic fatty liver disease (NAFLD). 36 In an American study, APRI levels were associated with increased mortality from liver disease.…”

Section: Discussionmentioning

confidence: 99%

Derivation and validation of prognostic models for predicting survival outcomes in Acute‐on‐chronic liver failure patients

Rui

Yang

Guo

et al. 2021

Journal of Viral Hepatitis

View full text Add to dashboard Cite

Acute-on-chronic liver failure (ACLF) is a syndrome characterized by acute decompensation of chronic liver disease associated with high bacterial infection (BI) and shortterm mortality. However, many ACLF prognostic predictive modelsare complicated.The aim of this study is to develop prognostic models for ACLF patients to predict BI and mortality. We retrospective recruited 263 patients with ACLF from Shandong Provincial Hospital and Taizhou Enze Medical Center (Group) Enze Hospital. ACLF was defined according to the Asian Pacific Association for the Study of the Liver (APASL) criteria. Multivariable logistic regression was used to derive prediction models for occurring BI and 28-day mortality in ACLF patients. Ninety seven of 263 patients (37%) occurred BI and 41 of 155 (26%) died within 28 days of admission. C-reactive protein (CRP), glucose, and albumin were the independent predictors for occurring BI during the hospital stay. We also found that hepatic encephalopathy (HE), prothrombin time, activated partial thromboplastin time (APRI), and glucose were the independent predictors of 28-day mortality of ACLF patients. Using logistic regression model, we generated a new modified MELD model (M-MELD) by incorporating HE, APRI, and glucose. AUC of M-MELD model was 0.871, which were significantly higher than MELD score (AUC:0.734), MELD-Na score (AUC:0.742), and integrated MELD score (iMELD) (AUC:0.761). HE, MELD score, APRI, and blood glucose were independent risk factors for 28-day mortality of ACLF patients. The modified MELD

show abstract

Section: Discussionmentioning

confidence: 99%

Derivation and validation of prognostic models for predicting survival outcomes in Acute‐on‐chronic liver failure patients

Rui

Yang

Guo

et al. 2021

Journal of Viral Hepatitis

View full text Add to dashboard Cite

show abstract

“…Among these scoring systems, only MELDs has been evaluated to predict the progression to HBV-related ACLF. Although high MELDs was associated with progression to ACLF, the predictive value of MELDs was not satisfying with the AUROC ranged from 0.601 to 0.820 [1][2][3]9]. There are currently a few specifically designed predictive models for the progression of HBV-related ACLF superior to MELDs.…”

Section: Non-invasive Tools To Predict Hbv-related Aclfmentioning

confidence: 98%

“…Currently, non-invasive fibrosis models have been made use of to predict HBV-related ACLF in patients with acute exacerbation and severe acute exacerbation [9]. The results demonstrated that different thresholds of liver fibrosis are required to determine the development to HBV-related ACLF in patients with different degrees of liver injury.…”

Section: Non-invasive Tools To Predict Hbv-related Aclfmentioning

confidence: 99%

“…In the study published in this issue of Hepatology International, only Lok index was an independent risk factor associated with progression to ACLF among the four candidate non-invasive fibrosis models: AST-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4), Forns index and Lok index [9]. Thus, the validation of non-invasive fibrosis serum panels in predicting ACLF is questionable.…”

Section: Are Non-invasive Fibrosis Models Competent In Predicting Hbv-related Aclf?mentioning

confidence: 99%

See 1 more Smart Citation

Validation of non-invasive tools in predicting HBV-related acute-on-chronic liver failure

Chen

Ning

2021

Hepatol Int

View full text Add to dashboard Cite

“…Although liver biopsy remains the gold standard for assessing the degree of liver fibrosis, its clinical application is still limited due to its invasiveness, inconvenience, risk of complications, and sampling errors. In addition, it is not suitable for the dynamic monitoring of liver fibrosis changes (4). Therefore, a series of noninvasive indicators (e.g., serological markers or imaging findings) have been developed, but to date there is still no single indicator that can sensitively and accurately reflect the degree of liver fibrosis.…”

Section: Introductionmentioning

confidence: 99%

A noninvasive diagnostic model for significant liver fibrosis in patients with chronic hepatitis B based on CHI3L1 and routine clinical indicators

Huang¹,

Wu²,

Huang³

et al. 2021

Ann Palliat Med

View full text Add to dashboard Cite

Background: In consideration of the limitations of liver biopsy, the past years have seen a great advance in the application of noninvasive indices in assessing liver fibrosis. However, the accuracies of the existing indices to determine liver fibrosis in patients with chronic hepatitis B (CHB) are still unsatisfactory. Here, we established a noninvasive diagnostic model for assessing significant liver fibrosis (SLF) in CHB patients based on serum chitinase 3-like 1 (CH3L1) and routine clinical indicators. Methods: The clinical data of 337 CHB patients treated at Xiamen Hospital of Traditional Chinese Medicine from December 1, 2019, to September 30, 2020, were collected in this cross-sectional study. All the enrolled cases were randomly divided into a training cohort (n=270) and a validation cohort (n=67). The training cohort was further divided into a non-significant liver fibrosis (NSLF) group (stages S0-S1; n=189; used as the control group) and an SLF group (stage S2-S4; n=81) based on the Scheuer scoring system.Univariate and multivariate logistic regression analyses were performed to screen for independent predictors of SLF in CHB patients and to establish a diagnostic model. Results:The results of univariate and multivariate logistic regression analysis showed that CHI3L1, AFP and PLT were independent predictors of SLF in CHB patients, and the diagnostic model was established as follows: CHI3L1/AFP/PLT (CAP) = 0.600 × CHI3L1/upper limit of normal (ULN) + 0.252 × AFP/ULN -1.424 × PLT/lower limit of normal (LLN) -1.223. The area under the receiver operating characteristic (AUROC) of this model for the diagnosis of SLF in the training cohort and the validation cohort was 0.805 and 0.819, respectively, showing no statistically significant difference (P>0.05), and the AUROC for the diagnosis of SLF in the whole cohort was significantly higher than those of other noninvasive markers including aspartate transaminase to platelet ratio index (APRI), fibrosis 4 score (FIB-4) and CHI3L1 (all P<0.05). Conclusions:The newly established model has a good diagnostic efficacy for SLF in CHB patients and is superior to other noninvasive markers including APRI, FIB-4, and CHI3L1. Thus, it can be used as a noninvasive diagnostic index for liver fibrosis in CHB patients.

show abstract

Noninvasive assessment of liver fibrosis for predicting acute-on-chronic liver failure in patients with chronic hepatitis B

Cited by 8 publications

References 29 publications

Derivation and validation of prognostic models for predicting survival outcomes in Acute‐on‐chronic liver failure patients

Derivation and validation of prognostic models for predicting survival outcomes in Acute‐on‐chronic liver failure patients

Validation of non-invasive tools in predicting HBV-related acute-on-chronic liver failure

A noninvasive diagnostic model for significant liver fibrosis in patients with chronic hepatitis B based on CHI3L1 and routine clinical indicators

Contact Info

Product

Resources

About