| Title: | Early prediction of decompensation (EPOD) score: Non-invasive determination of cirrhosis decompensation risk |
| Journal: | Liver International |
| Published: | 3 Feb 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/35007409/ |
| DOI: | https://doi.org/10.1111/liv.15161 |
| URL: | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/liv.15161 |
| Citations: | 6 (5 in last 2 years) as of 8 Aug 2024 |
Publication 12566
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Abstract
BACKGROUND & AIMS: Decompensation is a hallmark of disease progression in cirrhotic patients. Early detection of a phase transition from compensated cirrhosis to decompensation would enable targeted therapeutic interventions potentially extending life expectancy. This study aims to (a) identify the predictors of decompensation in a large, multicentric cohort of patients with compensated cirrhosis, (b) to build a reliable prognostic score for decompensation and (c) to evaluate the score in independent cohorts.</p>
METHODS: Decompensation was identified in electronic health records data from 6049 cirrhosis patients in the IBM Explorys database training cohort by diagnostic codes for variceal bleeding, encephalopathy, ascites, hepato-renal syndrome and/or jaundice. We identified predictors of clinical decompensation and developed a prognostic score using Cox regression analysis. The score was evaluated using the IBM Explorys database validation cohort (N = 17662), the Penn Medicine BioBank (N = 1326) and the UK Biobank (N = 317).</p>
RESULTS: The new Early Prediction of Decompensation (EPOD) score uses platelet count, albumin, and bilirubin concentration. It predicts decompensation during a 3-year follow-up in three validation cohorts with AUROCs of 0.69, 0.69 and 0.77, respectively, and outperforms the well-known MELD and Child-Pugh score in predicting decompensation. Furthermore, the EPOD score predicted the 3-year probability of decompensation.</p>
CONCLUSIONS: The EPOD score provides a prediction tool for the risk of decompensation in patients with cirrhosis that outperforms well-known cirrhosis scores. Since EPOD is based on three blood parameters, only, it provides maximal clinical feasibility at minimal costs.</p>
8 Keywords
- Ascites
- Esophageal and Gastric Varices
- Gastrointestinal Hemorrhage
- Humans
- Liver Cirrhosis
- Prognosis
- Retrospective Studies
- Severity of Illness Index
18 Authors
- Annika R. P. Schneider
- Carolin V. Schneider
- Kai Markus Schneider
- Vanessa Baier
- Steffen Schaper
- Christian Diedrich
- Katrin Coboeken
- Hannah Mayer
- Wenyi Gu
- Jonel Trebicka
- Lars M. Blank
- Rolf Burghaus
- Joerg Lippert
- Daniel J. Rader
- Christoph A. Thaiss
- Jan-Frederik Schlender
- Christian Trautwein
- Lars Kuepfer
1 Application
| Application ID | Title |
|---|---|
| 71300 | Elucidating host-environment interactions in gastrointestinal diseases |
Enabling scientific discoveries that improve human health