Modified Liaoning Score to assess long-term mortality in patients with liver cirrhosis: a retrospective, observational, multicenter and international study

• Grant number: 22/07839-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2022
• End date: November 30, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Gomes Romeiro
• Grantee: Marcos Vinícius Tiveli Bernardinelli
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Liver cirrhosis is a chronic and prevalent liver disease, with high mortality that is difficult to predict, which can lead to serious complications such as esophageal varices,ascites, hepatic encephalopathy and hepatocellular carcinoma. Currently, the Child-Pugh and MELD scores are the most important prognostic predictors for patientswith liver cirrhosis. Recently, a new predictor of mortality in cirrhosis,called Liaoning score, was developed in 11 Hospitals of the Liaoning Province inChina for non-invasive prognostic assessment of cirrhotic patients. The threemain components of the Liaoning score are acute gastrointestinal bleeding, ascites andplatelets, variables generally available at the time of clinical assesment.Considering the relation between esophageal varices and cirrhotic patients, we tried tomodify the Liaoning score by combining laboratory parameters and clinical assessmentto assess long-term mortality in patients with liver cirrhosis. This studywill use a validation cohort and a derivation cohort to validate the Modified score ofLiaoning, containing more variables than the original score. First, competitive risk assessment models will be designed using the Fine and Gray method to identify theindependent predictors of death in the derivation cohort. The occurrence of liver transplantation will be considered as a competitive event in relation to death. Furthermore, the new equation to predict the prognosis of cirrhotic patients, alsoreferred to as the modified Liaoning score, will be developed based on theindependent predictors with regression coefficients. Finally, the analysis of the time-dependent receptor operation characteristic curve (t-ROC) will be made toevaluate the performance of the modified Liaoning score, comparing this new scorewith the original Liaoning score and others that are better known (ChildPugh classification and MELD score) as prognostic predictors of cirrhotic patients during thefollow-up period.