The value of non-invasive tests for risk stratification in patients with compensated cirrhosis

Year 2016, Special Issue :2 Gastroenterology and Hepatology Viral Hepatitis, 55 - 58, 01.08.2016

Juan Abraldes

https://doi.org/10.5472/MMJsi.2901.11

Abstract

Liver cirrhosis is characterized by a long compensatedphase, with a median survival from diagnosis of around12 years. When decompensation occurs (variceal bleeding,jaundice, hepatic encephalopathy or ascites) the expectedmedian survival is around two years [1,2]. Whereas there area number of well-validated scores for prognosis predictionand risk stratification in patients with decompensatedcirrhosis, these are very limited in the case of compensatedcirrhosis [1]. The two most widely validated prognosticfactors in compensated cirrhosis are the presence of clinicallysignificant portal hypertension (CSPH) [3], defined asa hepatic venous pressure gradient ≥10 mmHg, and thepresence of esophageal varices [1]. The gold standard teststo assess CSPH and varices are hepatic vein catheterismand endoscopy, respectively [4]. However, these tests,especially hepatic vein catheterism, are relatively invasiveand impractical for the frequent follow-up of these patients.This has fostered the interest in the use of non-invasive toolsfor the assessment of patients with compensated cirrhosis.

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