ArticleClinical and experimental medicine2025
Liver stiffness measurement-based risk score for predicting liver decompensation risk: a single-center retrospective Chinese study.
Article in Clinical and experimental medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
Abstract
Liver decompensation represents a critical milestone in compensated advanced chronic liver disease (cACLD). Liver stiffness measurement (LSM) has emerged as a valuable non-invasive marker. This study aimed to develop an LSM-based liver decompensation risk prediction. We retrospectively recruited 1064 cACLD patients (LSM ≥ 10 kPa), divided into derivation (n = 745) and validation (n = 319) groups. Fine-Gray competing risk regression identified independent risk factors. Optimal cut-off values for risk stratification were determined using X-tile software. Model performance was evaluated using C-index and calibration curves. The main etiology was hepatitis B virus infection (69.8%). During follow-up, 328 patients (30.8%) developed liver decompensation with median decompensation time of 33 (16-50) months. Six independent predictors were identified: age, LSM, spleen diameter, hemoglobin, platelet, and international normalized ratio. The model demonstrated good discrimination [C-index: 0.779 (0.714-0.845)], calibration and overall performance (Brier Score 0.139). LSM contributed significantly (likelihood ratio test = 47.99, P < 0.001) with hazard ratio increasing substantially when LSM > 20 kPa. Patients were stratified using optimal cut-offs into low-risk (≤ 147.7 points), medium-risk (147.7-206.6 points), and high-risk (≥ 206.6 points) groups, with decompensation rates of 13.4%, 58.0%, and 86.7%, respectively, and median time to decompensation of 37 (18-55), 33 (15-50), and 28 (17-48) months, respectively. Cumulative decompensation incidences differed significantly among risk groups (Gray's test, P < 0.001). A user-friendly web-based LSM-Based Liver Decompensation Risk Score assessment tool was developed. Despite single-center retrospective design, hepatitis B focus, and lacking external validation, the LSM-based model effectively identified high-risk patients, providing valuable clinical decision support.
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