Predictive Factors and Time to Development of Hepatic Decompensation in Patients with Non-alcoholic Fatty Liver Disease

Heidi S Ahmed; Natalie Pedersen; Manju Bengaluru Jayanna; Patrick Ten Eyck; Antonio Sanchez; Arvind R Murali

doi:10.1007/s11606-020-05725-1

Back

Predictive Factors and Time to Development of Hepatic Decompensation in Patients with Non-alcoholic Fatty Liver Disease

Journal article

Open access

Peer reviewed

Predictive Factors and Time to Development of Hepatic Decompensation in Patients with Non-alcoholic Fatty Liver Disease

Heidi S Ahmed, Natalie Pedersen, Manju Bengaluru Jayanna, Patrick Ten Eyck, Antonio Sanchez and Arvind R Murali

Journal of general internal medicine : JGIM, Vol.35(5), pp.1523-1529

05/2020

DOI: 10.1007/s11606-020-05725-1

PMCID: PMC7210346

PMID: 32157645

Files and links (1)

url

https://doi.org/10.1007/s11606-020-05725-1View

Published (Version of record) Open Access

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of cirrhosis in the USA. We aimed to determine the time to develop hepatic events in patients with NAFLD and develop a simple model to identify patients at risk for hepatic decompensation. Retrospective cohort study. Seven hundred patients with NAFLD met inclusion criteria for the study. Patients were divided into model construction (n = 450) and validation (n = 250) cohorts. Demographic, clinical, and laboratory variables were gathered at the time of diagnosis of NAFLD. Kaplan-Meier analysis determined the time to development of hepatic events from initial diagnosis. A time-to-event prediction model was established in the model construction cohort using the multivariate Cox proportional hazards model and was then internally validated. Forty-nine (7%) patients developed hepatic events at a mean duration of 6.2 ± 4.2 years from initial diagnosis. Kaplan-Meier probability of developing a hepatic event at 5-, 10-, and 12-year intervals was 4.8%, 10.6%, and 11.3%, respectively. Age, presence of diabetes, and platelet count were identified as significant variables to predict hepatic events. NAFLD decompensation risk score was developed as "age × 0.06335 + presence of diabetes (yes = 1, no = 0) × 0.92221 - platelet count × 0.01522" to predict the probability of hepatic decompensation. Risk score model had an area under the curve of 0.89 (95% CI = 0.92, 0.86) and it performed well in both the validation (0.91, 0.87-0.94) and the overall cohort (0.89, 0.87-0.91). A significant proportion of patients with NAFLD developed hepatic decompensation. We have provided a simple, objective model to help identify "at-risk" patients.

Humans

Liver Cirrhosis

Non-alcoholic Fatty Liver Disease - complications

Non-alcoholic Fatty Liver Disease - diagnosis

Non-alcoholic Fatty Liver Disease - epidemiology

Retrospective Studies

Risk Factors

Details

Title: Subtitle: Predictive Factors and Time to Development of Hepatic Decompensation in Patients with Non-alcoholic Fatty Liver Disease
Creators: Heidi S Ahmed - University of Iowa Hospitals and Clinics
Natalie Pedersen - University of Iowa Hospitals and Clinics
Manju Bengaluru Jayanna - Lankenau Institute for Medical Research
Patrick Ten Eyck - University of Iowa
Antonio Sanchez - University of Iowa
Arvind R Murali - University of Iowa
Resource Type: Journal article
Publication Details: Journal of general internal medicine : JGIM, Vol.35(5), pp.1523-1529
DOI: 10.1007/s11606-020-05725-1
PMID: 32157645
PMCID: PMC7210346
ISSN: 0884-8734
eISSN: 1525-1497
Grant note: T32 DK007201 / NIDDK NIH HHS UL1 TR002537 / NCATS NIH HHS
Language: English
Date published: 05/2020
Academic Unit: Gastroenterology and Hepatology; Biostatistics; Internal Medicine
Record Identifier: 9984359832202771

Metrics

27 Record Views

6 Times Cited - Web of Science

See more details