Liver fibrosis scores help predict poor outcomes in seniors
Liver fibrosis scores aid in predicting the risk of poor health outcomes among elderly adults, a recent study has shown.
The study included 962 participants (mean age, 74.4±6.9 years; 55.5 percent female) who were followed for a mean of 95.7 months. Four liver fibrosis scores were assessed: fibrosis-4 (FIB-4), nonalcoholic fatty live disease (NAFLD) fibrosis score (NFS), aspartate aminotransferase-to-alanine aminotransferase ratio (AST/ALT) and the BARD score.
A total of 330 deaths were reported, resulting in an overall rate of 34.4 percent. There were also 139 cases (14.9 percent) of cardiovascular (CV) disease, 74 (7.9 percent) of neoplasms and 25 (2.7 percent) of respiratory diseases.
Those at intermediate (hazard ratio [HR], 1.51, 95 percent CI, 1.16–1.96) and high (HR, 2.86, 2.12–3.85) risk of fibrosis, as evaluated by the FIB-4, were significantly more likely to die of all causes. The same was true for CV mortality (intermediate: HR, 1.96, 1.33–2.9; high: HR, 3.57, 2.27–5.62).
Participants in the intermediate (overall mortality: adjusted HR, 1.78, 1.29–2.47; CV mortality: adjusted HR, 2.9, 1.80–4.66) and high (overall mortality: adjusted HR, 1.6, 1.21–2.1; CV mortality: adjusted HR, 2.42, 1.61–3.64) risk classes, as determined by the NFS, were also significantly more likely to suffer from poor outcomes.
In comparison, both intermediate and high fibrosis risk categories, as classified by the AST/ALT ratio, were associated only with overall mortality. Outcome prediction according to BARD, on the other hand, was significant only for those categorized with high risk of fibrosis.