TY - JOUR T1 - Two-dimensional shear wave elastography predicts survival in advanced chronic liver disease JF - Gut JO - Gut SP - 402 LP - 414 DO - 10.1136/gutjnl-2020-323419 VL - 71 IS - 2 AU - Jonel Trebicka AU - Wenyi Gu AU - Victor de Ledinghen AU - Christophe Aubé AU - Aleksander Krag AU - Michael Praktiknjo AU - Laurent Castera AU - Jerome Dumortier AU - David Josef Maria Bauer AU - Mireen Friedrich-Rust AU - Stanislas Pol AU - Ivica Grgurevic AU - Rongqin Zheng AU - Sven Francque AU - Halima Gottfriedovà AU - Sanda Mustapic AU - Ioan Sporea AU - Annalisa Berzigotti AU - Frank Erhard Uschner AU - Benedikt Simbrunner AU - Maxime Ronot AU - Christophe Cassinotto AU - Maria Kjaergaard AU - Filipe Andrade AU - Martin Schulz AU - Georg Semmler AU - Ida Tjesic Drinkovic AU - Johannes Chang AU - Maximilian Joseph Brol AU - Pierre Emmanuel Rautou AU - Thomas Vanwolleghem AU - Christian P Strassburg AU - Jerome Boursier AU - Philip Georg Ferstl AU - Ditlev Nytoft Rasmussen AU - Thomas Reiberger AU - Valerie Vilgrain AU - Aymeric Guibal AU - Olivier Guillaud AU - Stefan Zeuzem AU - Camille Vassord AU - Xue Lu AU - Luisa Vonghia AU - Renata Senkerikova AU - Alina Popescu AU - Cristina Margini AU - Wenping Wang AU - Maja Thiele AU - Chrisitan Jansen Y1 - 2022/02/01 UR - http://gut.bmj.com/content/71/2/402.abstract 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.All data relevant to the study are included in the article or uploaded as online supplemental information. ER -