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©The Author(s) 2025.
World J Hepatol. Mar 27, 2025; 17(3): 104580
Published online Mar 27, 2025. doi: 10.4254/wjh.v17.i3.104580
Published online Mar 27, 2025. doi: 10.4254/wjh.v17.i3.104580
Table 3 Summary of prognostic factors in liver disease: Advantages and limitations
Parameter | Description | Advantages | Disadvantages |
Child-Pugh score | Liver function assessment based on 5 variables: Bilirubin, albumin, INR, ascites and encephalopathy | Extensive clinical experience, easy to calculate, divides patients into 3 severity classes | Subjective variables |
MELD | Considers bilirubin, creatinin and INR | Objective, widely used, predicts mortality and need for transplantation | Does not account for other relevant prognostic indicators |
Hepatic venous pressure gradient | Invasive measurement of hepatic venous pressure gradient | Predictive of survival, reflects cirrhosis severity and complication risk, adds value to MELD | Invasive method, influenced by medications and other pathological conditions, not always available |
Early prediction of decompensation score | Score based on albumin, bilirubin, platelets | High sensitivity in predicting decompensation, simple and quick to calculate | Limited validation |
ALBI | Based on albumin and bilirubin | It assess hepatic functional reserve, greater sensitivity in detecting mild liver function deterioration | Does not account for other relevant prognostic indicators |
ALBI-FIB-4 | Combines ALBI and FIB-4 | Identify the risk of decompensation, improves prediction compared to MELD in high-risk groups, useful for risk stratification of decompensation | Limited validation |
FIB-4 | Score including age, transaminases and platelets | Simple, valid for estimating hepatic FIB and predicting adverse events like hepatocellular carcinoma and transplant | Limited to FIB evaluation, not always useful for advanced cirrhosis or non-fibrotic liver diseases |
Nonalcoholic fatty liver disease FIB score | Score considering body mass index, glucose levels, transaminases, platelets, age and albumin | Valid for estimating hepatic FIB, predictor of cardiovascular events, mortality and liver-related event risks | Primarily applicable to metabolic dysfunction-associated fatty liver disease patients |
Sarcopenia (CT and US) | Measurement of muscle mass, with CT as the gold standard and US as an alternative | CT is accurate and provides a reliable muscle mass measurement. US is less expensive, less invasiv and more accessible | CT is costly and not always available. US depends on the operator’s skill and there are no cut-off for diagnosis of sarcopenia |
Hand grip strength | Measurement of muscle strength via hand grip, an indicator of overall muscle strength | Simple, inexpensive, non-invasive, useful for diagnosing sarcopenia and monitoring muscle changes | Does not directly measure muscle mass, cut-off value varies across studies |
Artificial intelligence | Use of deep convolutional neural networks applied to CT images to automatically analyze muscle mass | High precision and consistency, reduces workload and increases efficiency | Requires computational resources and specialized training, further clinical validations needed |
MiRNA (miR-21, miR-1, miR-133) | Small non-coding molecules that regulate gene expression and influence muscle biology, with implications for sarcopenia | Regulate muscle metabolism and are involved in muscle atrophy and FIB. Possible diagnostic and prognostic applications | Role still unclear, further research is needed to clarify their clinical applications in cirrhosis and sarcopenia |
- Citation: Del Cioppo S, Faccioli J, Ridola L. Hepatic cirrhosis and decompensation: Key indicators for predicting mortality risk. World J Hepatol 2025; 17(3): 104580
- URL: https://www.wjgnet.com/1948-5182/full/v17/i3/104580.htm
- DOI: https://dx.doi.org/10.4254/wjh.v17.i3.104580