RT Journal Article
SR Electronic
T1 Two-dimensional shear wave elastography predicts survival in advanced chronic liver disease
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP gutjnl-2020-323419
DO 10.1136/gutjnl-2020-323419
A1 Jonel Trebicka
A1 Wenyi Gu
A1 Victor de Ledinghen
A1 Christophe Aubé
A1 Aleksander Krag
A1 Michael Praktiknjo
A1 Laurent Castera
A1 Jerome Dumortier
A1 David Josef Maria Bauer
A1 Mireen Friedrich-Rust
A1 Stanislas Pol
A1 Ivica Grgurevic
A1 Rongqin Zheng
A1 Sven Francque
A1 Halima Gottfriedovà
A1 Sanda Mustapic
A1 Ioan Sporea
A1 Annalisa Berzigotti
A1 Frank Erhard Uschner
A1 Benedikt Simbrunner
A1 Maxime Ronot
A1 Christophe Cassinotto
A1 Maria Kjaergaard
A1 Filipe Andrade
A1 Martin Schulz
A1 Georg Semmler
A1 Ida Tjesic Drinkovic
A1 Johannes Chang
A1 Maximilian Joseph Brol
A1 Pierre Emmanuel Rautou
A1 Thomas Vanwolleghem
A1 Christian P Strassburg
A1 Jerome Boursier
A1 Philip Georg Ferstl
A1 Ditlev Nytoft Rasmussen
A1 Thomas Reiberger
A1 Valerie Vilgrain
A1 Aymeric Guibal
A1 Olivier Guillaud
A1 Stefan Zeuzem
A1 Camille Vassord
A1 Xue Lu
A1 Luisa Vonghia
A1 Renata Senkerikova
A1 Alina Popescu
A1 Cristina Margini
A1 Wenping Wang
A1 Maja Thiele
A1 Chrisitan Jansen
YR 2021
UL http://gut.bmj.com/content/early/2021/01/20/gutjnl-2020-323419.abstract
AB 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.