ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2009 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top760.jpg" width="760" height="181" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> CIRRHOSIS AND COMPLICATIONS - b)CLINICAL ASPECTS<br><b>Presentation Date:</b> Apr 23, 2009</P><h2 align='left'><b> PROGNOSTIC VALUE OF TRANSIENT ELASTOGRAPHY AND NON-INVASIVE MARKERS OF FIBROSIS IN PATIENTS WITH CHRONIC LIVER DISEASE. A PROSPECTIVE ANALYSIS OF 4,935 PERSON-YEARS</b></h2> <p align='left'><b>J. Vergniol</b>, J. Foucher, E. Terrebonne, J. Font, W. Merrouche, P. Couzigou, V. de Ledinghen<br> <em>Hopital Haut Leveque, Pessac, France</em></p><br> <p align='justify'>The aim of this prospective study was to compare the 5-year prognostic value of transient elastography (TE), FibroTest (FT), APRI, FIB-4, Lok, and Child-Pugh score for predicting overall and specific survival, and cirrhosis decompensation in patients with chronic liver disease. <br>FibroScan and biomarkers were assessed in a cohort of 1346 patients (mean age 51 years) between April 2003 and February 2005. Median follow-up was 44 months (CI 95% 40-50). Aetiologies of liver diseases were HCV infection in 956 cases, HBV in 102, HIVHCV in 63, alcohol in 149, NAFLD in 72, HBVHCV in 4. <br>A total of 92 patients died (61 specific deaths from liver disease). At 50 months, overall survival was 92%. Overall survival and specific survival were significantly lower in patients with TE >20 kPa, FT >0.74, APRI >2, FIB-4 >3, Lok >0.5, Child-Pugh score > 6 (p< 0.0001). Portal hypertension worsening, and hepatocellular carcinoma development were significantly more frequent in patients with TE >20 kPa, FT >0.74, APRI >2, FIB-4 >3, LOK >0.5, Child-Pugh score > 6 (p< 0.0001) (Kaplan-Meier survival).<br>By multivariate analysis, factors associated with overall survival were TE > 20 kPa (OR 6.9 CI95% 3.2-14.8, p< 0.0001), FT > 0.74 (2.1, 1.1-4.2, p=0.03) and FIB-4 > 3 (3.0, 1.3-7.0, p=0.01). Only TE > 20 kPa (OR 7.7, 3.0-20.1, p< 0.0001) was associated with specific survival. Factors associated with portal hypertension worsening were TE > 20 kPa (p< 0.0001), FT > 0.74 (p=0.009) and Lok>0.5 (p=0.002). No factor was associated with hepatocellular carcinoma development. <br>TE has a better predictor than other tests for overall survival with area under the ROC curve of 0,86 (CI95% 0.81-0.91) vs 0,83 (95%CI 0,78-0,89) for FT and FIB-4, 0.83 (0.78-0.88) for Lok, 0.76 (0.69-0.82) for APRI, and 0.64 (0.58-0.72) for Child-Pugh Score > 6. <br>In conclusion, all non-invasive methods have a prognostic value in patients with chronic liver disease. However, TE is the only method associated with both overall and specific survival and portal hypertension worsening, even by comparison with Child-Pugh score > 6. Therefore, TE could be very useful for the decision of TIPS insertion or liver transplantation.</p> <br><a href='Session-Category 2b.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>