Non-invasive evaluation of liver fibrosis by transient elastography and biochemical markers in elderly inpatients

Aim. -The objective of this study was to evaluate liver fibrosis using non-invasive methods in elderly patients. Methods. - In a prospective two-day study, all. consecutive patients of geriatric units were examined using transient etastography (FibroScan (R)) and biochemical markers (Hepascore, Aspartate Transaminase (AST) to platelet ratio index [APRI], Forns score, FibroTest (R)). Three groups of patients were included: elderly patients without liver disease (group A, 85.2 +/- 7.3 years); healthy younger control subjects without Liver fibrosis (group B, 46.4 +/- 15.2 years); and elderly patients with confirmed liver disease (group C, 82.4 +/- 2.3 years). Results. - FibroScan (R) results in the elderly patients correlated well with fibrosis surrogates, but were more difficult to obtain than in the younger subjects. Mean Liver stiffness was 6.1 kPa (groupA) versus 4.9 kPa (groupB) and versus 10.2 kPa (group C) (P<0.0001). FibroTest (R) results were 0.5 in groupA versus 0.2 in groupB, and versus 0.6 in group C (P<0.0001). In groupA, statistical analysis showed that diabetes was associated with advanced liver fibrosis (FibroScan (R) >= 9.5 kPa). A body mass index greater than 26kg/m(2), age greater than 85 years, comorbidity score and polymedication were not associated with fibrosis. Conclusion. - Although liver stiffness may be more difficult to assess in the elderly, FibroScan (R) may nevertheless serve as a new, non-invasive method for detecting liver fibrosis in this population. (c) 2008 Elsevier Masson SAS. All rights reserved.