1. Simple non-invasive scoring systems and histological scores in predicting mortality in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis
- Author
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Tiankuo Yang, Lang Bai, Michael Pavlides, Dong-Bo Wu, Hong Li, Hong Tang, Wei Jiang, Wen-Ting Zhang, Antonio Gil-Gómez, Ling-Yun Zhou, Lingyao Du, Jia-Xu Liang, Vincent Wai-Sun Wong, Jian-Gao Fan, Chang-Hai Liu, Javier Ampuero, Manuel Romero-Gómez, and Ying Shi
- Subjects
medicine.medical_specialty ,Predictingmortality ,Cirrhosis ,Key wordshistological scores ,NAS histological features ,Severity of Illness Index ,Gastroenterology ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Decompensation ,Proportional Hazards Models ,Hepatology ,business.industry ,Incidence ,Fatty liver ,Hazard ratio ,Prognosis ,medicine.disease ,Simple non-invasive scoring systems ,Confidence interval ,030220 oncology & carcinogenesis ,Meta-analysis ,030211 gastroenterology & hepatology ,business ,Non-alcoholic fatty liver disease - Abstract
[Background and Aim] There is debate among the hepatology community regarding the simple non-invasive scoring systems and histological scores (even it was developed for histological classification) in predicting clinical outcomes in patients with non-alcoholic fatty liver disease (NAFLD). This study aimed to determine whether the presence of simple non-invasive scoring systems and histological scores could predict all-cause mortality, liver-related mortality, and liver disease decompensation (liver failure, cirrhosis, hepatocellular carcinoma, or decompensated liver disease)., [Methods] The pooled hazard ratio of prognostic factors and incidence rate per 1000 person-years in patients with NAFLD was calculated and further adjusted by two different models of handling the duplicated data., [Results] A total of 19 longitudinal studies were included. Most simple non-invasive scoring systems (Fibrosis-4 Score, BARD, and aspartate aminotransferase-to-platelet ratio index ) and histological scores (NAFLD activity score, Brunt, and "steatosis, activity, and fibrosis" ) failed in predicting mortality, and only the NAFLD fibrosis score > 0.676 showed prognostic ability to all-cause mortality (four studies, 7564 patients, 118 352 person-years followed up, pooled hazard ratio 1.44, 95% confidence interval [CI] 1.05–1.96). The incidence rate per 1000 person-years of all-cause mortality, liver-related mortality, cardiovascular-related mortality, and liver disease decompensation resulted in a pooled incidence rate per 1000 person-years of 22.65 (14 studies, 95% CI 9.62–53.31), 3.19 (7 studies, 95% CI 1.14–8.93), 6.02 (6 studies, 95% CI 4.69–7.74), and 11.46 (4 studies, 95% CI 5.33–24.63), respectively., [Conclusion] Non-alcoholic fatty liver disease fibrosis score showed promising prognostic value to all-cause mortality. Most present simple non-invasive scoring systems and histological scores failed to predict clinical outcomes.
- Published
- 2021