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Title: Liver stiffness (Fibroscan®) is a predictor of all-cause mortality in people with non-alcoholic fatty liver disease.
Austin Authors: Braude, Michael;Roberts, Stuart;Majeed, Ammar;Lubel, John;Prompen, Jirayut;Dev, Anouk;Sievert, William;Bloom, Stephen;Gow, Paul J ;Kemp, William
Affiliation: Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
Gastroenterology and Hepatology, Monash Health, Clayton, Victoria, Australia
School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
Gastroenterology and Hepatology, Alfred Health, Melbourne, Victoria, Australia
Monash Central Clinical School, Monash University, Clayton, Victoria, Australia
Gastroenterology and Hepatology, Eastern Health, Box Hill, Victoria, Australia
Gastroenterology and Hepatology
Issue Date: 2023
Date: 2022
Publication information: Liver International: Official Journal of the International Association for the Study of the Liver 2023; 43(1):90-99
Abstract: Progressive liver fibrosis related to non-alcoholic fatty liver disease (NAFLD) is associated with all-cause and liver-related mortality. We assessed vibration-controlled transient elastography (VCTE) as a predictor of mortality. Data from patients who underwent VCTE for NAFLD at 4 large health services in Victoria, Australia between the years 2008 to 2019 were linked to state-wide data registries. Cause of death (COD) and predictors of all-cause mortality were subsequently analysed using descriptive statistics and Cox-proportional regression analysis. Of 7079 VCTE records submitted for data linkage, 6341 were matched via data registry linkage. There were 217 deaths over a 22,653 person-year follow-up. COD included malignancies other than hepatocellular carcinoma (HCC) (18.0%, n = 39), sepsis (16.1%, n = 35), decompensated liver disease (15.2%, n = 33), cardiac disease (15.2%, n = 33), and HCC 6.0% (n = 13). Controlled attenuation parameter (CAP) was not associated with mortality in univariable analysis (HR = 1.00, CI 1.0-1.0, p = 0.488). Mortality increased with liver stiffness measurement (LSM) (HR 1.02 per kilopascal, CI 1.01-1.03, p < 0.001), Charlson comorbidity index (CCI) (HR 1.32 for each point, CI 1.27-1.38, p <0.001), and age (HR 1.05 per annum, CI 1.03-1.07, p < 0.001) in multivariable analysis. LSM ≥ 10kPa suggestive of compensated advanced chronic liver disease (cACLD) was associated with mortality in multivariable analysis (HR 2.31, CI 1.73-3.09, p < 0.001). VCTE LSM, in addition to age and CCI, is independently associated with increased all-cause mortality in a large cohort with NAFLD.
DOI: 10.1111/liv.15415
Journal: Liver International
PubMed URL: 36050821
Type: Journal Article
Subjects: Charlson comorbidity index
Non-alcoholic fatty liver disease
cause of death, registries
elasticity imaging techniques
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