2007 Apr;45(4):846–854. Y HUANG,1,2 LA ADAMS,1,2 G MACQUILLAN,1,2 E ROSSI,3 M BULSARA,4 GP JEFFREY1,2 1School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, 2Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, Perth, Australia, 3Department of Anatomical Pathology, PathWest, QEII Medical Centre,

Perth, Australia, 4Institute of Health and Rehabilitation Research, University of Notre Dame, Perth, Australia Background: A number of serum models have been developed to predict liver fibrosis severity but few have been developed to directly predict clinical Selleckchem C59 wnt outcomes. This study aimed to develop novel serum models that predict the risk of liver related death or liver transplantation (LRD), hepatocellular carcinoma (HCC) and liver decompensation (LD) for chronic hepatitis C (CHC) patients. Methods: CHC patients from 1997 to 2012 were included and randomized into a training and validation set (2:1 ratio). Clinical outcomes were determined using population based data-linkage system. Hyaluronic acid (HA), bilirubin, GGT, α2-macroglobulin, ALT, AST, platelet count, prothrombin time, INR, ALP, creatinine and albumin results were available at entry into the study. The models were developed using cox

regression analysis. Results: 617 patients were included: 411 in the training set and 206 in the validation set. Mean follow up was 6 yr (range 0.1–14) during which 22 LRD, 23 HCC and 27 LD were observed. Using the training set, albumin, GGT, HA, age and sex were chosen in the final model to predict 10, 5 and 3 yr LRD with AUROC http://www.selleckchem.com/products/sch772984.html of 0.95 (95% CI, 0.91–0.99), 0.95 (95%CI, 0.9–1) and 0.96 (95% CI, 0.91–1) respectively. A cut point of 32.5 had a sensitivity of 80% and specificity of 97% to predict 3 yr LRD. A

cut point of 31 had a sensitivity of 93% and specificity of 85% to predict 10 yr LRD. Using these two cut points, patients were categorized into 3 risk groups with an annual incidence rate for SPTBN5 LRD of 0.1% (95%CI, 0.04–0.2%), 2% (95%CI, 0.3–3.8%) and 13.2% (95%CI, 4.1–22.3%) respectively (p < 0.001). Albumin, GGT, HA, age and sex were used to predict 10, 5 and 3 yr LD with AUROC of 0.89 (95%CI, 0.8–0.98), 0.9 (95%CI, 0.8–1) and 0.96 (95%CI, 0.93–0.99) respectively. A cut point of 33.5 achieved a sensitivity of 94% and a specificity of 84% to predict 5 yr LD. Using this cut point patients were divided into two risk groups with an annual incidence rate for LD of 0.2% (95%CI, 0.02–0.3%) and 5.8% (95%CI, 2.5–9.1%) respectively (p < 0.001). ALP, α2-macroglobulin, age and sex were chosen to predict 10, 5 and 3 yr HCC occurrence with AUROC of 0.93 (95%CI, 0.89–0.98), 0.95 (95%CI, 0.91–0.99) and 0.94 (95%CI, 0.90–0.99) respectively. A cut point of 12 had a sensitivity of 90% and specificity of 88% to predict 5 yr HCC occurrence.