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CHESS-SAVE Score to Stratify Decompensation Risk in Compensated Advanced Chronic Liver Disease (CHESS2102)

Conditions
Compensated Advanced Chronic Liver Disease
Interventions
Procedure: Esophagogasrtoduodendoscopy and liver stiffness
Procedure: hepatic venous pressure gradient
Registration Number
NCT04975477
Lead Sponsor
Hepatopancreatobiliary Surgery Institute of Gansu Province
Brief Summary

Compensated advanced chronic liver disease (cACLD) was associated with a high rate of variceal bleeding, ascites, and hepatic encephalopathy due to portal hypertension. In these patients, esophagogastroduodenoscopy and hepatic venous pressure gradient were recommended methods to evaluate portal hypertension. However, non-invasive predictors of outcomes to stratify care remains needed. Although the updated EASL guideline has recommended that patients with liver stiffness \>20kPa or platelets \<150\*10\^9/L had the high risk of decompensation, the criteria remains to be validated. This international multicenter study aims to develop a novel CHESS-SAVE score to further predict the risk of liver decompensation in cACLD patients.

Detailed Description

Compensated advanced chronic liver disease (cACLD) was associated with a high rate of variceal bleeding, ascites, and hepatic encephalopathy due to portal hypertension. In these patients, esophagogastroduodenoscopy and hepatic venous pressure gradient were recommended methods to evaluate portal hypertension. However, non-invasive predictors of outcomes to stratify care remains needed. Although the updated EASL guideline has recommended that patients with liver stiffness \>20kPa or platelets \<150\*10\^9/L had the high risk of decompensation, the criteria remains to be validated. This international multicenter study initialed and enrolled by Chinese Portal Hypertension Alliance (CHESS) aims to develop a novel CHESS-SAVE score to further predict the risk of liver decompensation in cACLD patients.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
1000
Inclusion Criteria
  • age more than 18 years;
  • fulfilled diagnosis of cACLD based on radiological, histological features of liver cirrhosis
Exclusion Criteria
  • prior liver decompensation;
  • hepatocellular carcinoma;
  • prior liver transplantation;
  • portal vein thrombosis;
  • antiplatelet or anticoagulation;
  • without screening EGD within six months of TE;
  • incomplete follow-up data.

HVPG cohort

Inclusion Criteria:

  • age more than 18 years;
  • fulfilled diagnosis of cACLD based on radiological, histological features of liver cirrhosis

Exclusion Criteria:

  • prior liver decompensation;
  • hepatocellular carcinoma;
  • prior liver transplantation;
  • portal vein thrombosis;
  • antiplatelet or anticoagulation;
  • without screening EGD within six months of TE;
  • without HVPG measurement;
  • non-sinusoidal portal hypertension.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Training cohortEsophagogasrtoduodendoscopy and liver stiffnessA cohort was used to develop the novel score for predicting liver decompensation
Validation cohortEsophagogasrtoduodendoscopy and liver stiffnessA cohort was used to validate the performance of novel score for predicting liver decompensation
Exploratory cohorthepatic venous pressure gradientA cohort was used to study the diagnostic value of novel score for clinically significant portal hypertension
Exploratory cohortEsophagogasrtoduodendoscopy and liver stiffnessA cohort was used to study the diagnostic value of novel score for clinically significant portal hypertension
Primary Outcome Measures
NameTimeMethod
Accuracy of the CHESS-SAVE score for predicting liver decompensation3 years

To assess the accuracy of the CHESS-SAVE score to predict liver decompensation in patients with compensated advanced chronic liver disease

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (7)

Ruijin Hospital

🇨🇳

Shanghai, China

Zagazig University Faculty of Medicine

🇪🇬

Zagazig, Egypt

Tianjin Second People's Hospital

🇨🇳

Tianjin, China

Hyogo College of Medicine

🇯🇵

Nishinomiya, Japan

Korea University Ansan Hospital

🇰🇷

Gyeonggi-do, Korea, Republic of

Ehime University Graduate School of Medicine

🇯🇵

Matsuyama, Japan

Institute of Liver and Biliary Sciences

🇮🇳

New Delhi, India

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