Non-Alcoholic Fatty Liver Disease Decompensation Risk Score Calculator

Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases and is highly prevalent in patients with metabolic disorders. Advanced liver fibrosis is the most significant predictor of disease progression, but may not be clinically obvious, and patients can progress to cirrhosis with hepatic decompensation requiring liver transplantation. As the incidence of NAFLD is increasing worldwide, it is essential to improve identification of patients at risk for progression to hepatic decompensation. The Iowa NAFLD Decompensation Risk score was developed and internally validated in a cohort of NAFLD patients without clinically obvious cirrhosis to help identify the probability of developing hepatic decompensation at 5, 10, and 12 years. The model had a 'c' statistic of 0.89 (0.86-0.92)1.

Diabetes
The calculator is intended for use by health care professionals. The calculator may be used in conjunction with relevant clinical information to determine the probability of developing hepatic decompensation in patients with nonalcoholic fatty liver disease. The calculator was developed to be used in patients with no clinical evidence of advanced fibrosis/cirrhosis. The calculator performs best in the population from which it was derived.

Formula:

Age × 0.06335 + presence of diabetes (yes = 1, no = 0) × 0.92221 − platelet count × 0.01522
Predicted probability S(t,P) = S0(t)(Hazard ratio (P)) where S0(t) is the baseline survival.
Baseline survival at 5 years 0.984, at 10 years 0.953, and 12 years 0.944

Reference:

Ahmed HS, Pedersen N, Jayanna MB, Ten Eyck P, Sanchez A, Murali AR. Predictive Factors and Time to Development of Hepatic Decompensation in Patients with Non-alcoholic Fatty Liver Disease. J Gen Intern Med. 2020 Mar 10. doi: 10.1007/s11606-020-05725-1. [Epub ahead of print]