P3825 - Comprehensive Score; New Noninvasive Score to Evaluate Hepatic Fibrosis

George Trad, MD¹, Karina Herrera, MD², Maryiam Syed, ³, John Ryan, MD³, Syed Abdul Basit, MD^3
1MountainView Hospital, Las Vegas, NV; ²Southern Hills Medical Center, Las Vegas, NV; ³Southern Hills Medical Center, Las Vegas, NV

Introduction: Early diagnosis of hepatic fibrosis is an essential step for proper management. Transient elastography is a non-invasive, fast, and reliable method that measures the stiffness and elasticity of the liver tissue, which facilitates accurate diagnosis of early-stage hepatic fibrosis. Patients’ history as well as laboratory studies consisting of AST, ALT, and platelet count have been combined in the past to form a scoring system that can predict the severity of hepatic fibrosis. Herein, we present a new scoring system that consists of patients’ age, gender, AST/ALT ratio, and platelet count to assess the degree of hepatic fibrosis.

Methods: We conducted a retrospective cohort study evaluating patients that have obtained a transient elastography test. A total of 188 patients were divided into two groups based on their fibrosis score. Group 1 included patients with fibrosis scores of F1 and F2 (2kPa-10kPa). Group 2 included patients with a fibrosis score of F3 (10kPa-14 kPa). A comprehensive score was then calculated for each patient. [Figure 1]. Sensitivity and specificity of patients with a score < 2 and patients with a score < 3 were calculated to identify the accuracy of the comprehensive score in predicting the degree of hepatic fibrosis.

Results: Out of the 188 patients, 35 patients had a comprehensive score of 2 or less, 136 patients had a comprehensive score of between 3 and 5, and 17 patients had a comprehensive score of 6 or more. [Table 1]. A comprehensive score of 2 or less had a negative predictive value of 96.51% to exclude any extensive fibrosis (F3-F4) with a sensitivity of 97.7% and specificity of 23.6% [Table 2]. A comprehensive score of 3 or less had a negative predictive value of 91.1% to exclude any extensive fibrosis (F3-F4) with a sensitivity of 81.10% and specificity of 61.10%. Increasing the cut-off on the scoring scale from 2 to 3 resulted in lower sensitivity.

Discussion: This study has demonstrated that the comprehensive scoring method is a non-invasive, cheap, and a convenient screening tool that can be obtained in an inpatient or outpatient setting to predict the degree of hepatic fibrosis and whether there is a need for further evaluation or not. Using a score of 2 as a cutoff to exclude hepatic fibrosis resulted in a higher sensitivity compared to score of 3. Given our study is retrospective with a sample of 188 patients, additional meta-analysis and prospective studies are required to obtain a larger sample for further validating the comprehensive score.



Disclosures:


George Trad, MD¹, Karina Herrera, MD², Maryiam Syed, ³, John Ryan, MD³, Syed Abdul Basit, MD³. P3825 - Comprehensive Score; New Noninvasive Score to Evaluate Hepatic Fibrosis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.