Predicting Hepatic Decompensation in Patients With Metabolic Dysfunction Associated Steatotic Liver Disease-Related Cirrhosis : The ABID-LSM Model
Calzadilla Bertot, Luis (Sir Charles Gairdner Hospital)
Soria, Anna (Hospital Clínic i Provincial de Barcelona)
Jiménez-Masip, Alba (Hospital Universitari Vall d'Hebron)
Serra Matamala, Isabel (Hospital Universitari de Girona Doctor Josep Trueta)
Broquetas, Teresa (Institut Hospital del Mar d'Investigacions Mèdiques)
Vergara, Mercedes (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Rodriguez Castellano, Adrià (Hospital Universitari Joan XXIII de Tarragona)
Aracil, Carlos (Hospital Arnau de Vilanova (Lleida, Catalunya))
El Maimouni, Cautar (Hospital Clínic i Provincial de Barcelona)
Muñoz-Martínez, S. (Hospital Universitari Vall d'Hebron)
Carrión Rodríguez, José Antonio (Hospital del Mar (Barcelona, Catalunya))
Pardo, Albert (Hospital Universitari Joan XXIII de Tarragona)
Pericàs, Juan M. (Hospital Universitari Vall d'Hebron)
Graupera, Isabel (Hospital Clínic i Provincial de Barcelona)
Adams, Leon A. (Sir Charles Gairdner Hospital (Nedlands, Austràlia))
Universitat Autònoma de Barcelona

Date:	2025
Abstract:	Background & Aims: Predicting the risk of hepatic decompensation guides prognostication and therapy; however, it is challenging in patients with cirrhosis due to metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to improve a previously developed predictive tool of hepatic decompensation in MASLD cirrhosis (ABIDE) by incorporating liver stiffness measurement (LSM). Methods: A multi-centre retrospective cohort of patients with compensated cirrhosis due to MASLD was identified, with decompensation incidence assessed using competing risk regression. The prognostic accuracy of a modified ABIDE model incorporating LSM (ABID-LSM) was assessed using time-dependent AUC (tAUC) and compared with other predictive models. Results: Out of 388 patients, 273 (70. 4%) had available LSM. Hepatic decompensation occurred in 54 (20%) patients during follow-up (median 31 months, range: 20-60). The predictive accuracy at 5 years of ABID-LSM (tAUC 0. 80) was better than ABIDE (tAUC 0. 75, p = 0. 03) and LSM (tAUC 0. 63, p < 0. 001). The ABID-LSM model calibrated well (slope 0. 99) with excellent overall performance (Integrated Brier Score 0. 15). A cut-off of 8. 1 separated those at high and low risk of hepatic decompensation at 5 years (24% vs. 5%, respectively, sHR = 4. 8, p < 0. 001). The ABID-LSM model had better predictive ability at 5 years than ALBI, FIB-4, NAFLD Decompensation Risk Score and ANTICIPATE models (all p < 0. 001) as well as hepatic vein pressure gradient measurement (tAUC 0. 78 vs. 0. 71, p < 0. 001, n = 60). Conclusions: The ABID-LSM model has greater accuracy in predicting hepatic decompensation in patients with cirrhosis due to MASLD than existing predictive models. If externally validated, ABID-LSM may identify those who benefit from pharmacotherapy and close monitoring.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Fatty liver ; Liver cirrhosis ; Liver related events ; Predictive model ; Prognosis
Published in:	Alimentary pharmacology & therapeutics, Vol. 62 Núm. 5 (september 2025) , p. 526-535, ISSN 1365-2036

DOI: 10.1111/apt.70215
PMID: 40491328

10 p, 449.0 KB

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Articles > Published articles