Combination of liver stiffness measurement and platelets count is a tool to safely rule out varices needing treatment (VNT) in patients with compensated advanced chronic liver disease (cACLD). Aims: to evaluate 4-year liver-related complications and survival in low-risk patients according to Baveno VI criteria.
we conducted a monocentric retrospective analysis of prospectively collected data of all consecutive patients, with cirrhosis (LSM≥12.5 kPa) and without previous complication, evaluated between 2012 and 2015. Liver-related complications and survival were compared between 2 groups of patients: favourable (LSM< 20 kPa and platelet count>150.000/mm3) and unfavourable Baveno VI status patients (LSM ≥ 20 kPa or platelet count ≤150.000/mm3).
455 patients with cACLD were analysed. Two hundred patients had favourable Baveno VI criteria, 3.6% with VNT. The 4-year probability of being free of acute decompensation was higher in low-risk patients (94.4 ± 1.8% vs. 85.7%±2.6%, p = 0.018). Unfavourable Baveno status was independently associated with acute decompensation. The probability of being free of HCC was significantly higher in low-risk patients (94.2 ± 1.8% vs. 87.6 ± 2.4%, p = 0.048). Liver-related mortality was not different between the 2 groups (p = 0.56).
The Baveno VI criteria could predict clinical outcome in cACLD.
Abbreviations:PHT (Portal hypertension), HE (Hepatic Encephalopathy), VB (Variceal Bleeding), VNT (Varices Needing Treatment), cACLD (compensated Advanced Chronic Liver Disease), LSM (Liver Stiffness Measurement), HVPG (Hepatic Venous Pressure Gradient), HCC (Hepatocellular Carcinoma), TE (Transient elastography), AST (Aspartate aminotransferase), ALT (Alanine aminotransferase), CHC (Chronic Hepatitis C), CHB (Chronic Hepatitis B), NASH (Non Alcoholic Steatohepatitis), SVR (sustained viral response), INR (International Normalized Ratio), BMI (Body Mass Index), MELD (Model for End-Stage Liver Disease), CI (Confidence Interval), PSVD (Porto-Sinusoidal Vascular Disease), cccDNA (covalently closed circular DNA), MAFLD (Metabolic Associated Fatty Liver Disease)
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Published online: September 25, 2021
Accepted: September 6, 2021
Received: May 13, 2021
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.