Document Detail


Enhanced liver fibrosis test can predict clinical outcomes in patients with chronic liver disease.
MedLine Citation:
PMID:  20675693     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinicians use fibrosis in a liver biopsy to predict clinical outcomes of chronic liver disease. The performance of non-invasive tests has been evaluated against histological assessment of fibrosis but use of clinical outcomes as the reference standard would be ideal. The enhanced liver fibrosis (ELF) test was derived and validated in a large cohort of patients and shown to have high diagnostic accuracy (area under the curve (AUC)=0.80 95% CI 0.76 to 0.85) in identification of significant fibrosis on biopsy.
OBJECTIVE: To evaluate ELF performance in predicting clinical outcomes by following up the original ELF cohort.
METHODS: Patients recruited to the ELF study at seven English centres were followed up for liver morbidity and mortality by examination of clinical data. Defaulting/discharged patients were followed up by family practitioner questionnaires. Primary outcome measure was liver-related morbidity/liver-related death.
RESULTS: 457 patients were followed up (median 7 years), with ascertainment of clinical status in 92%. There were 61 liver-related outcomes (39 deaths). Survival analysis showed that the ELF score predicts liver outcomes, with people having the highest ELF scores being significantly more likely to have clinical outcomes than those in lower-score groups. A Cox proportional hazards model showed fully adjusted HRs of 75 (ELF score 12.52-16.67), 20 (10.426-12.51) and 5 (8.34-10.425) compared with patients with ELF <8.34. A unit change in ELF is associated with a doubling of risk of liver-related outcome.
CONCLUSIONS: An ELF test can predict clinical outcomes in patients with chronic liver disease and may be a useful prognostic tool in clinical practice.
Authors:
Julie Parkes; Paul Roderick; Scott Harris; Christopher Day; David Mutimer; Jane Collier; Martin Lombard; Graeme Alexander; John Ramage; Geoffrey Dusheiko; Mark Wheatley; Carol Gough; Alastair Burt; William Rosenberg
Related Documents :
10076783 - Amantadine hydrochloride decreases serum alt activity without effects on serum hcv-rna ...
12626283 - Clinical correlation of antimitochondrial antibodies.
22591733 - Flow control techniques for onyx embolization of intracranial dural arteriovenous fistu...
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-07-30
Journal Detail:
Title:  Gut     Volume:  59     ISSN:  1468-3288     ISO Abbreviation:  Gut     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-10-07     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  1245-51     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Biological Markers / blood
Biopsy
Chronic Disease
Epidemiologic Methods
Female
Humans
Liver / pathology
Liver Cirrhosis / diagnosis*,  etiology,  pathology
Male
Middle Aged
Outcome Assessment (Health Care) / methods
Prognosis
Young Adult
Grant Support
ID/Acronym/Agency:
G106/1138//Medical Research Council; //Medical Research Council
Chemical
Reg. No./Substance:
0/Biological Markers
Comments/Corrections
Comment In:
Gut. 2011 Oct;60(10):1442-3; author reply 1443-4   [PMID:  21159895 ]
Gut. 2010 Sep;59(9):1165-7   [PMID:  20587543 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The management of gastric polyps.
Next Document:  Early features of acute-on-chronic alcoholic liver failure: a prospective cohort study.