European Journal of Gastroenterology & Hepatology最新文献

{"title":"Combination of fibrosis-4 score and D-dimer: a practical approach to identify poor outcome in COVID-19.","authors":"Fernanda Manhães Pozzobon, Ronir Raggio Luiz, Júlia Gomes Parente, Taísa Melo Guarilha, Maria Paula Raymundo Cunha Fontes, Maria Chiara Chindamo, Renata de Mello Perez","doi":"10.1097/MEG.0000000000002966","DOIUrl":"10.1097/MEG.0000000000002966","url":null,"abstract":"<p><strong>Aim: </strong>Fibrosis-4 (FIB-4) score and D-dimer (DD) have emerged as prognostic markers in coronavirus disease 2019 (COVID-19). However, precise cutoff points remain undefined, and their combined use has been scarcely studied. We aimed to analyze FIB-4 and DD performance, individually and combined, to predict outcomes among COVID-19 patients.</p><p><strong>Methods: </strong>From March to December 2020, hospitalized COVID-19 patients were evaluated based on clinical and laboratory tests from their first day of hospitalization. Primary outcome was inhospital mortality, and secondary outcomes included hospital stay length, ICU admission and duration, need for hemodialysis, ventilatory support, and extent of lung involvement. Optimal FIB-4 and DD cutoff points to predict mortality were established to maximize sensitivity and specificity. A sequential diagnostic strategy using both markers was subsequently evaluated.</p><p><strong>Results: </strong>Among 518 patients (61 ± 16 years, 64% men), the inhospital mortality rate was 18%. FIB-4 outperformed DD in predicting mortality (area under the receiver operating characteristic curve: 0.76 vs. 0.65, P  = 0.003) and was chosen as the first step in sequential analysis. Mortality was higher in patients with FIB-4 ≥1.76 vs. FIB-4 <1.76 (26 vs. 5%, P  < 0.001) and DD ≥2000 ng/ml vs. DD <2000 ng/ml (38 vs. 16%, P  < 0.001). Using FIB-4 as a screening test (cutoff = 1.76, 90% sensitivity) followed by DD (cutoff = 2000 ng/ml; 90% specificity) identified a subgroup with higher mortality when compared with FIB-4 alone (48 vs. 26%, P  < 0.001), missing the identification of only 2% of deaths.</p><p><strong>Conclusion: </strong>Sequential use of FIB-4 and DD represents a comprehensive strategy to identify high-risk COVID-19 patients at hospital admission, potentially minimizing unnecessary DD tests in those deemed low-risk by FIB-4.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"955-960"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The usefulness of serum leucine-rich alpha-2 glycoprotein as a novel biomarker in monitoring inflammatory bowel disease: a systematic review and meta-analysis.","authors":"Fatemeh Ojaghi Shirmard, Seyed Morteza Pourfaraji, Behrad Saeedian, Tannaz Bagheri, Abdulrahman Ismaiel, Satohiro Matsumoto, Nastaran Babajani","doi":"10.1097/MEG.0000000000002952","DOIUrl":"10.1097/MEG.0000000000002952","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a condition of unknown origin. It does not have a definite cure and its response to various treatments can be evaluated based on symptom-based measures, invasive procedures, or biomarker levels, highlighting the need for an accurate biomarker. Since C-reactive protein (CRP) and fecal calprotectin have their shortcomings, the need for a novel biomarker remains critical. Systematic searches of PubMed, Scopus, Web of Science, and Embase were performed In January 2024. PROSPERO number is CRD42024507383. We assessed the accuracy of leucine-rich alpha-2 glycoprotein (LRG) in identifying disease activity among patients with IBD using a bivariate diagnostic random-effects model. Fourteen studies involving 1794 individuals conducted in Japan were selected for our systematic review. The sensitivity and specificity of LRG levels for detecting disease activity were analyzed in patients with IBD and in two subgroups (ulcerative colitis and Crohn's disease). The synthesized sensitivity and specificity were 75.4% [95% confidence interval (CI), 68.9-80.9%] and 77.3% (95% CI, 69.9-83.2%), respectively, in patients with IBD, 73.1% (95% CI, 62.7-81.5%) and 81.9% (95% CI, 73.9-87.8%), respectively, in patients with CD, and the secondary analysis of the ulcerative colitis subgroup showed a pooled sensitivity and specificity of 72.8 and 59.7%, respectively. Our systematic review and meta-analysis demonstrated that LRG could be useful in detecting IBD activity. It is superior for detecting disease activity, especially in patients with normal CRP levels. The LRG was more accurate in monitoring disease activity in patients with CD than in patients with IBD.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"891-904"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing diagnostic accuracy for HBV-related cirrhosis progression: predictive modeling using combined Golgi protein 73 and α1-microglobulin for the transition from nondecompensated to decompensated cirrhosis.","authors":"Meixia Du, Huai Li, Tao Li, Ouyang Yi, Binqing Xiao, Mengni Zhen, Jianyong Jiang, Yongzhong Li","doi":"10.1097/MEG.0000000000002970","DOIUrl":"10.1097/MEG.0000000000002970","url":null,"abstract":"<p><strong>Background and aims: </strong>Chronic hepatitis B poses a major health risk, especially its progression to decompensated cirrhosis. Early prediction is crucial for better outcomes. This study evaluated the predictive power of Golgi protein 73 (GP73), α1-microglobulin (α1M), age, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count (PLT) using machine learning models.</p><p><strong>Methods: </strong>A total of 179 patients (69 healthy controls, 59 with decompensated cirrhosis, and 51 with nondecompensated liver disease) were analyzed. Five random forest models incorporating different combinations of variables, including GP73, α1M, age, AST, ALT, PLT, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) index were assessed using area under the curve (AUC) and accuracy. Logistic regression and a decision tree were also employed.</p><p><strong>Results: </strong>Random forest model 3 (age + GP73 + α1M + AST + ALT + PLT) achieved the highest AUC (0.96) and accuracy (0.90), outperforming model 4 (age + APRI + FIB-4 + GP73 + α1M, AUC: 0.96, accuracy: 0.76), and logistic regression (AUC: 0.91, accuracy: 0.86). GP73 and PLT were the most significant predictors of cirrhosis progression. There were nonlinear interactions between GP73 and α1M. When PLT levels were ≤143 × 10 9 /L, patients with GP73 > 0.168 ng/L or ≤ 0.117 ng/L indicated an increased risk of decompensated cirrhosis.</p><p><strong>Conclusion: </strong>The combination of GP73, α1M, age, AST, ALT, and PLT enhances prediction accuracy for the progression from nondecompensated to decompensated hepatitis B virus-related cirrhosis, with GP73 and α1M showing nonlinear interactions influenced by PLT levels.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"961-969"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden of liver cancer due to hepatitis B, 1990-2021 and projections to 2051: a systematic analysis of the Global Burden of Disease Study 2021.","authors":"Peipei Yang, Wenjie Huang, Yuanyuan Xu, Qiurong Li, Xinyan Shu, Jiaqian Zuo, Wenqin Ren, Yujie Huang, Yuhao Teng, Peng Shu","doi":"10.1097/MEG.0000000000003053","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003053","url":null,"abstract":"<p><strong>Purpose: </strong>Using the Global Burden of Disease 2021 data, this study reports the global, regional, and national disease burden of liver cancer due to hepatitis B (LCDHB) from 1990 to 2021, stratified by age, sex, and sociodemographic index (SDI), and projects future burden to 2051.</p><p><strong>Methods: </strong>We examined incidence, deaths, and disability-adjusted life years (DALYs) of LCDHB. Age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), and age-standardized DALYs rates were analyzed (1990-2021). Spearman correlation assessed age-standardized rates-SDI relationships. The Bayesian age-period-cohort (BAPC) model projected the burden to 2051.</p><p><strong>Results: </strong>Compared to 1990, the number of LCDHB incidences, deaths, and DALYs increased by 46.9, 41.2, and 33.9% in 2021; however, from 1990 to 2021, the ASIR, ASDR, and age-standardized DALYs rate all exhibited a declining trend. In 2021, the highest ASIR occurred in East Asia, High-income Asia Pacific, and Western sub-Saharan Africa. At the national and regional levels, Mongolia, the Republic of Paraguay, and the Commonwealth of the Bahamas showed peak ASIR. ASIR was higher in males and increased with age, peaking at 85-89 age group for both males and females in 2021. A reverse U-shaped correlation existed between age-standardized DALYs and SDI during 1990-2021. BAPC projections indicate declining global ASIR, ASDR, and age-standardized DALYs rates (2021-2051).</p><p><strong>Conclusion: </strong>Despite rising incidence, deaths, and DALYs, LCDHB treatment challenges persist, especially for males and elderly populations. Our findings on epidemiological trends and demographic variations provide crucial insights for policymakers addressing this global health burden.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting alanine aminotransferase distribution among US adults, the National Health and Nutrition Examination Survey 1988-2020.","authors":"Cyrille Kouambo Beckodro, Nazish Masud, Arshpreet Kaur Mallhi, Queeneth Edwards, Samuel O Nwaobi, Yudan Wei, Jian Zhang","doi":"10.1097/MEG.0000000000003055","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003055","url":null,"abstract":"<p><strong>Background: </strong>The dynamics of alanine aminotransferase (ALT) remain poorly described in the general population owing to the unavailability of widely accepted cutoffs to define abnormal levels and insensitivity of dichotomized ALT values.</p><p><strong>Methods: </strong>With data from the National Health and Nutrition Examination Survey 1988-1994 (n = 11 854), 1999-2004 (12 280), 2005-2010 (14 204), 2011-2016 (14 145), and 2017-2020 (7047), we examined the age- and sex-standardized distribution of log-transformed serum ALT and tested the elevated ALT prevalence trend among American adults aged 19 years and older.</p><p><strong>Results: </strong>The ALT geometric mean increased from 15.89 U/L (95% confidence interval = 15.43-16.37) in 1988-1994 to 21.97 U/L (21.75-22.20) in 1999-2004. The means remained around 22 U/L between 2004 and 2016 and then decreased to 19.19 U/L (18.85-19.54) in 2017-2020 (P for quadratic trends <0.001). However, the 95th percentile of the bell-distribution remained around 49 U/L by the end of the study after jumping from 38.39 U/L (35.73-41.06) in 1988-1994 to 48.86 U/L (47.34-50.39) in 1999-2004. Correspondingly, the elevated ALT prevalence doubled from 1988-1994 to 1999-2004 and remained unchanged through 2020, independent of the cutoffs used.</p><p><strong>Conclusions: </strong>The ALT mean level decreased in recent years, but the right end of the bell-shaped distribution was stagnant, and the elevated ALT prevalence levels remained persistently high. The reductions in ALT levels likely corresponded to population-wide reductions in fructose consumption. The prevalent elevated ALT requires effective clinical interventions.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic esophagitis is the leading cause of dysphagia in an outpatient setting.","authors":"Manuele Furnari, Francesco Calabrese, Andrea Pasta, Elisa Marabotto, Luca Barbera, Giorgia Bodini, Edoardo V Savarino, Vincenzo Savarino, Patrizia Zentilin, Edoardo G Giannini","doi":"10.1097/MEG.0000000000003048","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003048","url":null,"abstract":"<p><strong>Background and aim: </strong>Dysphagia is an alarming symptom often associated with upper gastrointestinal organic diseases. Its incidence has increased in the last decades, although updated clinical data related to patients presenting with dysphagia are lacking. Thus, in this study, we aimed to provide an update of the main characteristics of patients presenting with dysphagia to an outpatient clinic.</p><p><strong>Methods: </strong>We retrospectively evaluated consecutive patients first referred to our outpatient clinic (June 2021-December 2022) for dysphagia as the main symptom. All patients underwent upper digestive endoscopy as the first diagnostic examination, with or without biopsies. According to clinician assessment, patients also underwent high-resolution manometry (HRM).</p><p><strong>Results: </strong>During the study period, a total of 78 patients met the inclusion criteria. Endoscopy showed abnormal features in 25 patients (32.1%), and the most common findings were those associated with eosinophilic esophagitis (n = 8, 10.3%). Biopsies of the esophagus and/or cardia were obtained in 61 patients (78.2%), and 28 patients had abnormal histologic findings. Overall, the most common histological diagnosis was eosinophilic esophagitis, identified in 12 patients (15.3%), with 4/12 (33.3%) without endoscopic alterations suggestive of this diagnosis. HRM was performed in 34/78 patients (43.6%), and in these patients, achalasia was the most common diagnosis (7/34, 20.6%).</p><p><strong>Conclusion: </strong>Among patients complaining of dysphagia referred to an outpatient gastroenterology clinic, eosinophilic esophagitis is the most common underlying cause of the symptom. Given its high frequency, biopsies should always be performed in patients with dysphagia, regardless of endoscopic findings.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease burden, diagnosis pathways and treatment patterns in patients with eosinophilic esophagitis: a real-world study.","authors":"Christopher Ma, Ulrike von Arm, Frank Zerbib, Tiffany Pela, Amr Radwan, Juby A Jacob-Nara, Rohan C Parikh, Kinga Borsos, Fareedat Bello, Ryan B Thomas, Sarette T Tilton","doi":"10.1097/MEG.0000000000003049","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003049","url":null,"abstract":"<p><strong>Background: </strong>Despite a rising prevalence of eosinophilic esophagitis (EoE), real-world data on current management challenges remain limited.</p><p><strong>Objective: </strong>To evaluate demographic and clinical characteristics, treatment patterns, and health outcomes in patients with EoE.</p><p><strong>Methods: </strong>Physicians from Canada, France, Germany, Spain, and the UK retrospectively reviewed records of patients (aged ≥12 years) who were newly diagnosed with EoE between January 2009 and December 2019. EoE diagnosis was confirmed by esophageal biopsy demonstrating a peak eosinophil count ≥15 eosinophils/high-power field (eos/hpf) within 90 days before or after the documented diagnosis (index). Included patients had ≥1 follow-up endoscopy with biopsy and known eosinophil count within 24 months. Data on demographics, clinical characteristics, treatment, and health outcomes were collected 12-month preindex to the last record entry/death.</p><p><strong>Results: </strong>Overall, 415 patients [mean age (SD): 31.8 (14.6) years] were included. The mean (SD) diagnostic delay from symptom onset was 3.4 (4.8) years [median (range): 1.7 (0.7-4.0)]. The average eosinophil count was 41.4 eos/hpf; 80.2% of patients had endoscopic abnormalities of the esophagus at diagnosis. Post-EoE diagnosis, 77.1% of patients received proton-pump inhibitors, 68.2% swallowed topical corticosteroids, 48.4% made dietary modifications, and 18.8% had esophageal dilation. At diagnosis, 74.5% of patients had dysphagia and 46.0% had heartburn. After diagnosis, 63.5%, 62.2%, and 57.6% did not achieve histologic remission (<15 eos/hpf) at the first, second, and third endoscopy, respectively.</p><p><strong>Conclusion: </strong>Patients with EoE experience a substantial disease burden, with a significant delay in diagnosis. Achieving optimal disease control remains an unmet need with conventional nonbiologic therapies.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic comparative study in patients with liver cirrhosis and hepatocellular carcinoma related to hepatitis B virus infection.","authors":"Yanping Wang, Huan Wang, Shuai Wei, Zhiliang Gao, Haili Gao, Xinwei Wang, Haijun Liang, Daokun Yang","doi":"10.1097/MEG.0000000000003021","DOIUrl":"10.1097/MEG.0000000000003021","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hepatitis B virus (HBV) infection can increase the risk of developing liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Timely detection of precancerous lesions for patients with chronic HBV infection is critical in preventing worse consequences. The purpose of this study is to reveal the key serum metabolic biomarkers that can be applied to the early recognition of HCC in patients with HBV-associated cirrhosis.</p><p><strong>Methods: </strong>Blood samples from patients with LC, HCC, and healthy subjects were collected, and endogenous metabolites in serum were detected by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Differential metabolites (DM) were screened, and metabolic pathways and Kyoto Encyclopedia of Genes and Genomes signals involved in DM were analyzed.</p><p><strong>Results: </strong>Metabolomics results revealed that patients with LC and HCC had significantly different metabolic characteristics. Patients with LC and HCC shared 22 biomarkers, LC had six different biomarkers, and HCC had 10 different biomarkers. The expressions of these metabolites all showed significant differences between groups. Pathway enrichment analysis revealed that the differential biomarkers of LC were primarily involved in the regulation of phospholipid biosynthesis, while the differential biomarkers of HCC were mainly involved in the regulation of endogenous androgen signaling, mitochondrial fatty acid metabolism, and purine metabolism signaling. The common biomarkers are enriched in bile acid metabolism, amino acid metabolism, and arachidonic acid metabolism.</p><p><strong>Conclusion: </strong>We clarified the blood metabolism characteristics of LC and HCC. These findings provided potential endogenous metabolic indicators for early recognition of HBV-chronically infected cirrhotic patients who may progress to HCC.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient elastography can stratify patients with Child Pugh A cirrhosis according to long-term risk of decompensation: a longitudinal cohort study.","authors":"Paul Armstrong, Aoife Moriarty, Audrey Dillon, Zita Galvin, Jennifer Russell, Stephen Stewart","doi":"10.1097/MEG.0000000000003045","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003045","url":null,"abstract":"<p><strong>Objective: </strong>There are no robust noninvasive tools to predict long-term liver-related events in well-compensated cirrhosis. We assessed the performance of noninvasive fibrosis tools in predicting decompensation, hepatocellular carcinoma (HCC), and liver-related mortality (LRM) within a mixed aetiology Child Pugh A cirrhosis cohort.</p><p><strong>Design: </strong>Patients were followed in a single centre for 10 years. The primary outcome was decompensation (ascites, encephalopathy, or variceal bleeding). Secondary outcomes were HCC and LRM. All patients received baseline transient elastography for liver stiffness measurement (LSM) and blood tests to calculate Fibrosis-4 (FIB-4).</p><p><strong>Results: </strong>In 114 patients, 31% decompensated during the follow-up period. 11% developed HCC. Increased LSM is associated with greater decompensation risk (P = 0.007). When controlling for FIB-4 and alcohol consumption, for each 1 kPa increase, the 10-year risk of decompensation increased by 2.2% [P = 0.009, hazard ratio: 1.022, 95% confidence interval (CI): 1.01-1.04]. Ten-year risk of decompensation was 20% for LSM < 21 kPa, 32% in the 21-35 kPa group, and 47% in the ≥35 kPa group (P = 0.019). After censoring for HCC, index LSM was associated with risk of death or liver transplant [odds ratio (OR): 1.029 (95% CI: 1-1.06) P = 0.039]. FIB-4 is associated with HCC risk (P = 0.001) with an OR: 1.16 (95% CI: 1.01-1.32).</p><p><strong>Conclusion: </strong>Ten-year risk of decompensation increased with increasing LSM in mixed aetiology compensated cirrhosis. LSM can be used to risk-stratify real-world patients, in order to reassure those at lowest risk and potentially focus resources on patients with higher scores and greatest decompensation risk.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of transient ascites drainage in hospitalized patients with large ascites.","authors":"Golo Petzold, Gesine Graw, Fani Delistefani, Richard Friedemann Knoop, André Sasse, Volker Ellenrieder, Albrecht Neesse, Ahmad Amanzada","doi":"10.1097/MEG.0000000000003038","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003038","url":null,"abstract":"<p><strong>Objectives: </strong>Single paracentesis is the standard treatment for large ascites. An alternative is the placement of a transient ascites drainage. This study aimed to evaluate the efficacy and safety of transient ascites drainage in patients with large ascites.</p><p><strong>Methods: </strong>Patients with symptomatic ascites who underwent transient ascites drainage between January 2017 and February 2022 were enrolled in this study. The amount of drained ascites and the duration of the drainage stay were recorded. Drainage-associated acute complications have been documented. Risk factors for complications were analyzed.</p><p><strong>Results: </strong>A total of 224 ascites drains were inserted into 177 patients. The mean cumulative volume of drained ascites was 14 284 ml (±9987). The duration of drainage varied between 0 and 42 days and averaged 8.57 days (±6.51). The technical success rate of drain placement was 98.21% (220/224). The most common drainage-associated complications were acute kidney injury in 31/224 (13.84%), bacterial peritonitis 16/185 (8.65%), and drainage-associated fistula [21/224 (9.38%)]. There were significant differences between the groups with and without drainage-associated peritonitis in the duration of drainage stay [13.63 (±8.13) vs. 8.06 (±6.20) days; P = 0.001). The frequency of peritonitis with a length of drainage stay of up to 7 days was 1.92%, with a length of stay greater than 7 days 17.28% (P < 0.001).</p><p><strong>Conclusion: </strong>Transient ascites catheters are effective for the drainage of large-volume ascites. The technical success rate was high, and the procedure itself was safe; however, owing to the high rate of drainage-associated peritonitis, a longer duration of drainage should be avoided.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}