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Abstract：
UNASSIGNED: The NAFLD decompensation risk score (the Iowa Model) was recently developed to identify patients with nonalcoholic fatty liver disease (NAFLD) at highest risk of developing hepatic events using three variables-age, platelet count, and diabetes.
UNASSIGNED: We performed an external validation of the Iowa Model and compared it to existing non-invasive models.
UNASSIGNED: We included 249 patients with NAFLD at Boston Medical Center, Boston, Massachusetts, in the external validation cohort and 949 patients in the combined internal/external validation cohort. The primary outcome was the development of hepatic events (ascites, hepatic encephalopathy, esophageal or gastric varices, or hepatocellular carcinoma). We used Cox proportional hazards to analyze the ability of the Iowa Model to predict hepatic events in the external validation (https://uihc.org/non-alcoholic-fatty-liver-disease-decompensation-risk-score-calculator). We compared the performance of the Iowa Model to the AST-to-platelet ratio index (APRI), NAFLD fibrosis score (NFS), and the FIB-4 index in the combined cohort.
UNASSIGNED: The Iowa Model significantly predicted the development of hepatic events with hazard ratio of 2.5 [95% confidence interval (CI) 1.7-3.9, P < 0.001] and area under the receiver operating characteristic curve (AUROC) of 0.87 (CI 0.83-0.91). The AUROC of the Iowa Model (0.88, CI: 0.85-0.92) was comparable to the FIB-4 index (0.87, CI: 0.83-0.91) and higher than NFS (0.66, CI: 0.63-0.69) and APRI (0.76, CI: 0.73-0.79).
UNASSIGNED: In an urban, racially and ethnically diverse population, the Iowa Model performed well to identify NAFLD patients at higher risk for liver-related complications. The model provides the individual probability of developing hepatic events and identifies patients in need of early intervention.
UNASSIGNED: We performed an external validation of the Iowa Model and compared it to existing non-invasive models.
UNASSIGNED: We included 249 patients with NAFLD at Boston Medical Center, Boston, Massachusetts, in the external validation cohort and 949 patients in the combined internal/external validation cohort. The primary outcome was the development of hepatic events (ascites, hepatic encephalopathy, esophageal or gastric varices, or hepatocellular carcinoma). We used Cox proportional hazards to analyze the ability of the Iowa Model to predict hepatic events in the external validation (https://uihc.org/non-alcoholic-fatty-liver-disease-decompensation-risk-score-calculator). We compared the performance of the Iowa Model to the AST-to-platelet ratio index (APRI), NAFLD fibrosis score (NFS), and the FIB-4 index in the combined cohort.
UNASSIGNED: The Iowa Model significantly predicted the development of hepatic events with hazard ratio of 2.5 [95% confidence interval (CI) 1.7-3.9, P < 0.001] and area under the receiver operating characteristic curve (AUROC) of 0.87 (CI 0.83-0.91). The AUROC of the Iowa Model (0.88, CI: 0.85-0.92) was comparable to the FIB-4 index (0.87, CI: 0.83-0.91) and higher than NFS (0.66, CI: 0.63-0.69) and APRI (0.76, CI: 0.73-0.79).
UNASSIGNED: In an urban, racially and ethnically diverse population, the Iowa Model performed well to identify NAFLD patients at higher risk for liver-related complications. The model provides the individual probability of developing hepatic events and identifies patients in need of early intervention.
摘要：
■最近开发了NAFLD失代偿风险评分（Iowa模型），用于识别非酒精性脂肪性肝病（NAFLD）患者发生肝脏事件的风险最高，使用三个变量-年龄，血小板计数,和糖尿病。
■我们对爱荷华州模型进行了外部验证，并将其与现有的非侵入性模型进行了比较。
■我们纳入了波士顿医疗中心的249名NAFLD患者，波士顿,马萨诸塞州,外部验证队列中的949例患者和内部/外部联合验证队列中的949例患者。主要结果是肝脏事件的发展（腹水，肝性脑病,食管或胃静脉曲张，或肝细胞癌）。我们使用Cox比例风险来分析Iowa模型在外部验证（https://uihc.org/非酒精性脂肪肝疾病失代偿风险评分计算器）中预测肝脏事件的能力。我们将爱荷华州模型的性能与AST与血小板比率指数(APRI)进行了比较，NAFLD纤维化评分（NFS），和合并队列中的FIB-4指数。
■Iowa模型显著预测了肝脏事件的发展，风险比为2.5[95%置信区间(CI)1.7-3.9，P<0.001]，受试者工作特征曲线下面积(AUROC)为0.87(CI0.83-0.91)。爱荷华州模型的AUROC（0.88，CI：0.85-0.92）与FIB-4指数（0.87，CI：0.83-0.91）相当，高于NFS（0.66，CI：0.63-0.69）和APRI（0.76，CI：0.73-0.79）。
■在城市，种族和种族不同的人口，Iowa模型在确定肝脏相关并发症风险较高的NAFLD患者方面表现良好.该模型提供发生肝脏事件的个体概率，并识别需要早期干预的患者。
■我们对爱荷华州模型进行了外部验证，并将其与现有的非侵入性模型进行了比较。
■我们纳入了波士顿医疗中心的249名NAFLD患者，波士顿,马萨诸塞州,外部验证队列中的949例患者和内部/外部联合验证队列中的949例患者。主要结果是肝脏事件的发展（腹水，肝性脑病,食管或胃静脉曲张，或肝细胞癌）。我们使用Cox比例风险来分析Iowa模型在外部验证（https://uihc.org/非酒精性脂肪肝疾病失代偿风险评分计算器）中预测肝脏事件的能力。我们将爱荷华州模型的性能与AST与血小板比率指数(APRI)进行了比较，NAFLD纤维化评分（NFS），和合并队列中的FIB-4指数。
■Iowa模型显著预测了肝脏事件的发展，风险比为2.5[95%置信区间(CI)1.7-3.9，P<0.001]，受试者工作特征曲线下面积(AUROC)为0.87(CI0.83-0.91)。爱荷华州模型的AUROC（0.88，CI：0.85-0.92）与FIB-4指数（0.87，CI：0.83-0.91）相当，高于NFS（0.66，CI：0.63-0.69）和APRI（0.76，CI：0.73-0.79）。
■在城市，种族和种族不同的人口，Iowa模型在确定肝脏相关并发症风险较高的NAFLD患者方面表现良好.该模型提供发生肝脏事件的个体概率，并识别需要早期干预的患者。
