Dynamics in Liver Stiffness Measurements Predict Outcomes in Advanced Chronic Liver Disease

Background &amp; Aims:Liver stiffness measurements (LSMs) provide an opportunity to monitor liver disease progression and regression noninvasively. We aimed to determine the prognostic relevance of LSM dynamics over time for liver-related events and death in patients with chronic liver disease. Methods:Patients with chronic liver disease undergoing 2 or more reliable LSMs at least 180 days apart were included in this retrospective cohort study and stratified at baseline (BL) as nonadvanced chronic liver disease (non-ACLD, BL-LSM &lt; 10 kPa), compensated ACLD (cACLD; BL-LSM ≥ 10 kPa), and decompensated ACLD. Data on all consecutive LSMs and clinical outcomes were collected. Results: There were 2508 patients with 8561 reliable LSMs (3 per patient; interquartile range, 2–4) included: 1647 (65.7%) with non-ACLD, 757 (30.2%) with cACLD, and 104 (4.1%) with decompensated ACLD. Seven non-ACLD patients (0.4%) and 83 patients with cACLD (10.9%) developed hepatic decompensation (median follow-up, 71 months). A 20% increase in LSM at any time was associated with an approximately 50% increased risk of hepatic decompensation (hazard ratio, 1.58; 95% CI, 1.41–1.79; P &lt;.001) and liver-related death (hazard ratio, 1.45; 95% CI, 1.28–1.68; P &lt;.001) in patients with cACLD. LSM dynamics yielded a high accuracy to predict hepatic decompensation in the following 12 months (area under the receiver operating characteristics curve = 0.933). The performance of LSM dynamics was numerically better than dynamics in Fibrosis-4 score (0.873), Model for End-Stage Liver Disease (0.835), and single time-point LSM (BL-LSM: 0.846; second LSM: 0.880). Any LSM decrease to &lt;20 kPa identified patients with cACLD with a substantially lower risk of hepatic decompensation (hazard ratio, 0.13; 95% CI, 0.07–0.24). If reliable, LSM also confers prognostic information in decompensated ACLD. Conclusions: Repeating LSM enables an individual and updated risk assessment for decompensation and liver-related mortality in ACLD.</p

Adolf Schmitt-Weigand. — Rechtspflegedelikte in der fränkischen Zeit. Münsterische Beiträge zur Rechts-und Staatswissenschaft.

Semmler Josef. Adolf Schmitt-Weigand. — Rechtspflegedelikte in der fränkischen Zeit. Münsterische Beiträge zur Rechts-und Staatswissenschaft.. In: Cahiers de civilisation médiévale, 6e année (n°21), Janvier-mars 1963. pp. 72-74

Il monachesimo e la riforma ecclesiastica (1049-1122). Atti della quarta Settimana intern. di studio, Mendola, 23-29 agosto 1968

Semmler Josef. Il monachesimo e la riforma ecclesiastica (1049-1122). Atti della quarta Settimana intern. di studio, Mendola, 23-29 agosto 1968. In: Cahiers de civilisation médiévale, 15e année (n°60), Octobre-décembre 1972. pp. 329-334

Harold Willjung, ed. Das Konzil van Aachen 809.

Semmler Josef. Harold Willjung, ed. Das Konzil van Aachen 809.. In: Revue belge de philologie et d'histoire, tome 78, fasc. 2, 2000. Histoire medievale. moderne: et contemporaine - Middeleeuwse, modhrnf en hedendaagse geschiedenis. pp. 570-573

H.E.J. Cowdrey. — The Cluniacs and the Gregorian Reform

Semmler Josef. H.E.J. Cowdrey. — The Cluniacs and the Gregorian Reform. In: Cahiers de civilisation médiévale, 16e année (n°62), Avril-juin 1973. pp. 158-161

Mechthild Gretsch. The intellectual Foundation of the English Benedictine Reform

Semmler Josef. Mechthild Gretsch. The intellectual Foundation of the English Benedictine Reform. In: Revue belge de philologie et d'histoire, tome 78, fasc. 2, 2000. Histoire medievale. moderne: et contemporaine - Middeleeuwse, modhrnf en hedendaagse geschiedenis. pp. 573-576

Harold Willjung, ed. Das Konzil van Aachen 809.

Semmler Josef. Harold Willjung, ed. Das Konzil van Aachen 809.. In: Revue belge de philologie et d'histoire, tome 78, fasc. 2, 2000. Histoire medievale. moderne: et contemporaine - Middeleeuwse, modhrnf en hedendaagse geschiedenis. pp. 570-573

Adolf Schmitt-Weigand. — Rechtspflegedelikte in der fränkischen Zeit. Münsterische Beiträge zur Rechts-und Staatswissenschaft.

Semmler Josef. Adolf Schmitt-Weigand. — Rechtspflegedelikte in der fränkischen Zeit. Münsterische Beiträge zur Rechts-und Staatswissenschaft.. In: Cahiers de civilisation médiévale, 6e année (n°21), Janvier-mars 1963. pp. 72-74

H.E.J. Cowdrey. — The Cluniacs and the Gregorian Reform

Semmler Josef. H.E.J. Cowdrey. — The Cluniacs and the Gregorian Reform. In: Cahiers de civilisation médiévale, 16e année (n°62), Avril-juin 1973. pp. 158-161