Liver stiffness measurement (LSM) by Vibration-controlled transient elastography (VCTE) predicts prognosis in patients with chronic liver disease

【Objectives】VCTE is a non-invasive imaging modality. This study investigated whether LSM by VCTE could predict prognosis in patients with chronic liver disease.
【Methods】1510 patients who underwent LSM at our hospital between 2013-2021 and were followed for at least 6 months were included.
【Results】The etiologies of liver disease were HBV: 17%, HCV: 31%, NAFLD: 23%, AIH: 4%, PBC: 9%, ALD: 6%, DILI: 3%, and other:7%. Seventy-three patients (4.8%) died during the median observation period of 4.2 years. This death group had significantly higher LSM values (11.9 vs. 5.5 kPa, P<0.0001), were more frequently male (71 vs. 43%, P<0.001), and exhibited lower platelet count (13.7 vs. 19.7 x10⁴/μL, P<0.0001) as well as higher liver enzyme (ALT, γ-GTP, and ALP) and fibrosis (FIB-4 index, APRI) scores. The AUROC of LSM for predicting all-cause death was 0.741, which was higher than those of FIB-4 index (0.731) and APRI (0.704). In additional analysis using propensity matching for age, sex, and FIB-4 index, LSM was significantly higher in the death group (11.9 vs. 5.8 kPa, P<0.0001). Cox proportional hazard analysis confirmed LSM ≧10 kPa (HR: 6.115, P<0.0001) as independent risk factors of mortality.
【Conclusion】LSM by VCTE is useful for predicting prognosis in patients with chronic liver disease.