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Liu C, Cao Z, Yan H, Wong YJ, Xie Q, Hirooka M, Enomoto H, Kim TH, Hanafy AS, Liu Y, Huang Y, Li X, Kang N, Koizumi Y, Hiasa Y, Nishimura T, Iijima H, Jung YK, Yim HJ, Guo Y, Zhang L, Ma J, Kumar M, Jindal A, Teh KB, Sarin SK, Qi X. Correction to: A Novel SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102): An International Multicenter Cohort Study. Am J Gastroenterol 2023:00000434-990000000-00822. [PMID: 37467451 DOI: 10.14309/ajg.0000000000002382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Chuan Liu
- CHESS Center, Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhujun Cao
- Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huadong Yan
- Department of Infectious Disease, Shulan Hospital, Hangzhou, China
| | - Yu Jun Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, SingHealth, Singapore
- Duke-NUS Medical School, Singapore
| | - Qing Xie
- Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Masashi Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Hirayuki Enomoto
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tae Hyung Kim
- Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Amr Shaaban Hanafy
- Division of Gastroenterology, Hepatology, and Endoscopy, Internal Medicine, Zagazig University Faculty of Medicine, Egypt
| | - Yanna Liu
- CHESS Center, Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yifei Huang
- CHESS Center, Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xiaoguo Li
- CHESS Center, Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ning Kang
- CHESS Center, Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yohei Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Takashi Nishimura
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
- Ultrasound Imaging Center, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Hiroko Iijima
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
- Ultrasound Imaging Center, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Young Kul Jung
- Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Hyung Joon Yim
- Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea
| | - Ying Guo
- Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
| | - Linpeng Zhang
- Department of Interventional Radiology, The Third People's Hospital of Taiyuan, Taiyuan, China
| | - Jianzhong Ma
- Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
| | - Manoj Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India
| | - Ankur Jindal
- Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India
| | - Kok Ban Teh
- Department of Gastroenterology and Hepatology, Changi General Hospital, SingHealth, Singapore
- Duke-NUS Medical School, Singapore
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India
| | - Xiaolong Qi
- CHESS Center, Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Wong YJ, Li J, Liu C, Chen Z, Chan YH, Putera M, Teh KB, Ang TL, Zhao L, Yan Z, Kumar R, Li X, Qi X. CHESS-ALARM score to stratify decompensation risk in compensated advanced chronic liver disease patients: An international multicenter study. J Gastroenterol Hepatol 2022; 37:1043-1051. [PMID: 35253271 DOI: 10.1111/jgh.15819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM A combination of platelet and elastography (PE criteria) was proposed to identify compensated advanced chronic liver disease (cACLD) patients at risk of liver decompensation. We aim to validate and refine PE criteria by developing a new predictive score to predict decompensation in Asian cACLD patients. METHODS An international cohort of 633 cACLD patients with liver stiffness measurement (LSM) and esophagogastroduodenoscopy performed were included. We validated PE criteria to predict first liver decompensation using competing risk analysis, with death and hepatocellular carcinoma as competing events. We developed a predictive model using proportional subdistribution hazard regression. Prognostic accuracy was compared with the model of end-stage liver disease (MELD), albumin-bilirubin (ALBI), and ALBI-FIB-4 score using time-dependent area under operative characteristic curve (tAUC). RESULTS Sixty patients developed decompensation over the median follow-up of 39 months. Favorable Baveno VI status ruled out cACLD patients at risk of liver decompensation. LSM > 25 kPa was suboptimal to predict cACLD patients who will develop liver decompensation. We developed CHESS-ALARM score by incorporating age, platelet, and gender into LSM. CHESS-ALARM score (tAUC = 0.86, 95% confidence interval [CI]: 0.79-0.94) has significantly higher accuracy than MELD (tAUC: 0.61), ALBI (tAUC: 0.62), ALBI-FIB-4 (tAUC: 0.70), and LSM > 25 kPa (tAUC: 0.54) to predict liver decompensation at 5 years (P < 0.05 for all). Patients with CHESS-ALARM score ≥ -0.37 had an 11-fold higher risk of decompensation (subdistribution hazard ratio = 11.2, 95% CI: 5.1-24.5). CONCLUSION CHESS-ALARM score can be readily incorporated into clinical practice of cACLD patients to estimate individual risk of liver decompensation; however, more data are required in morbidly obese cACLD patients of nonviral etiology.
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Affiliation(s)
- Yu Jun Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.,Duke-NUS Academic Medical Program, SingHealth, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jia Li
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Chuan Liu
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - Zhaojin Chen
- Biostatistic Unit, Yong Loo Lin School of Medicine, Singapore
| | - Yiong Huak Chan
- Biostatistic Unit, Yong Loo Lin School of Medicine, Singapore
| | - Martin Putera
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Kok Ban Teh
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Tiing Leong Ang
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.,Duke-NUS Academic Medical Program, SingHealth, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lili Zhao
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Zhongfang Yan
- Department of Radiology, Tianjin Second People's Hospital, Tianjin, China
| | - Rahul Kumar
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.,Duke-NUS Academic Medical Program, SingHealth, Singapore
| | - Xin Li
- Department of Clinical Nutrition, Tianjin Second People's Hospital, Tianjin, China
| | - Xiaolong Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
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Putera M, Teh KB, Kumar R, Wong YJ. Small esophageal varices in compensated cirrhosis patients: to treat or not to treat? J Hepatol 2021; 75:491-492. [PMID: 33716090 DOI: 10.1016/j.jhep.2021.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Martin Putera
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore Health Service, Singapore
| | - Kok Ban Teh
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore Health Service, Singapore
| | - Rahul Kumar
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore Health Service, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Medicine Academic Clinical Programme, SingHealth Duke-NUS, Singapore
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore Health Service, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Medicine Academic Clinical Programme, SingHealth Duke-NUS, Singapore.
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Teh KB, Loo JH, Tam YC, Wong YJ. Efficacy and safety of albumin infusion for overt hepatic encephalopathy: A systematic review and meta-analysis. Dig Liver Dis 2021; 53:817-823. [PMID: 34011479 DOI: 10.1016/j.dld.2021.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS The efficacy and safety of albumin infusion for treatment and prevention of overt hepatic encephalopathy (OHE) among cirrhosis patients remained controversial. We performed a systematic review and meta-analysis to evaluate the benefit of albumin infusion for the treatment and prevention of OHE. METHODS We performed a systematic search of 4 electronic databases up to 31st January 2021. The primary outcome was the resolution of OHE. Secondary outcomes were inpatient mortality and albumin-associated adverse events. We assessed the pooled odds' risk, pooled mean differences, 95% confidence interval and heterogeneity using Review Manager Version 5.3. RESULTS A total of 12 studies (2,087 subjects) were identified. Among cirrhosis patients with OHE, albumin infusion was associated with a lower pooled risk of OHE (OR=0.43, 95%CI: 0.27, 0.68; I2=0%). Among patients without baseline OHE, albumin infusion was associated with a lower pooled risk of developing OHE (OR=0.53, 95%CI: 0.32, 0.86; I2=62%). Albumin infusion was associated with a lower pooled risk of inpatient mortality (OR=0.36, 95%CI: 0.21, 0.60; I2=0%). CONCLUSION Well-powered randomized trials are required to confirm the benefits of albumin infusion for the prevention and treatment of overt hepatic encephalopathy among decompensated cirrhosis patients.
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Affiliation(s)
- Kok Ban Teh
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
| | - Jing Hong Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yew Chong Tam
- Department of Medicine, Singapore General Hospital, Singapore
| | - Yu Jun Wong
- Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Duke-NUS Academic Medicine Programme, Singhealth, Singapore.
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