Liver stiffness-based model predicts hepatic venous pressure gradient in patients with liver disease

Background: The aim was to develop a model to predict clinically significant portal hypertension, Methods: Patients who have been programmed for liver resection/transplantation were enrolled prospectively. Preoperative liver stiffness measurement (LSM), liver function test (LFT), and intraoperative HVPG were assessed. A probability score model to predict HVPG & GE;10 mmHg called HVPG10 score was developed and validated. Results: A total of 161 patients [66% men, median age of 63 years] were recruited for the study. Median LSM, and HVPG were 9.5 kPa, and 5 mmHg respectively. HVPG10 score was developed using independent predictors of HVPG >= 10 mmHg in the training set were LSM, total bilirubin, alkaline phosphatase, and international normalized ratio. Area under receiver operating curve of HVPG10 score in the training and validation sets were 0.91 and 0.93 respectively with a cutoff of 15. In the overall cohort, HVPG10 score & GE;15 had 83% accuracy, 90% sensitivity, 81% specificity and 96% negative predictive value in predicting HVPG & GE;10 mmHg. Conclusion: HVPG10 score is an easy-to-use noninvasive continuous scale tool to rule out clinically significant portal hypertension in > 95% patients with chronic liver disease.

Automated summary

The aim of this study was to develop a model to predict clinically significant portal hypertension. A HVPG10 score model was developed based on preoperative liver stiffness measurement, liver function test, and intraoperative HVPG. The score showed good predictive ability in both training and validation sets. This model is important for ruling out portal hypertension and has implications for patients with chronic liver disease.