Higher Liver Stiffness Predicting Adverse Outcomes in Cirrhotic Patients with Child-Pugh Grades A and B.

Objective: To describe the baseline characteristics and two-year outcomes of patients with Child-Pugh grades A and B cirrhosis; and evaluate the predictive value of liver stiffness for the development of adverse outcomes (AOs) in this patient population.

Study Design: A prospective cohort study.

Place And Duration Of Study: The Second Hospital, Cheeloo College of Medicine, Shandong University, China between September 2018 and March 2021.

Methodology: The present study consecutively included patients with Child-Pugh grades A and B cirrhosis. Patients were followed up every six months until two years. Baseline demographic characteristics and laboratory indexes were collected. Liver stiffness and controlled attenuation parameter were measured at baseline, month 6 and month 12. The observational endpoint was AOs, including liver-related patient death and hepatocellular carcinoma (HCC).

Results: A total of 174 patients were included in the final cohort. Hepatitis B virus (HBV)-induced liver cirrhosis accounted for the vast majority of enrolled cases (82.2%). AOs were observed in six patients. Multivariate logistic regression model was performed and liver stiffness was considered as the only independent predictor for AOs (OR 1.071, p = 0.006). Liver stiffness was also significantly improved at 12 months compared with the baseline data (median 10.6 vs. 13.3 kPa, p <0.001).

Conclusion: Patients with Child-Pugh grades A and B cirrhosis had an acceptable short-term prognosis. Greater liver stiffness predicted two-year AOs in these patients with relatively mild cirrhosis. The prognostic value of changes in liver stiffness warrants further investigation. Key Words: Liver cirrhosis, Child-Pugh score, Liver stiffness, Asian population, Outcome.