HCR.20.008 – Prediction of long-term outcome in patients presenting with liver cirrhosis in a North Holland metropolitan area: The Predictor trial

Route: Health care research, sickness prevention and treatment

Cluster question: 094 How do we improve the quality of health care as much as possible while keeping it affordable?

Background: Liver cirrhosis is a distinct pathological entity resulting from fibrosis formation from chronic liver injury. The natural course of the disease identifies two stages: compensated and decompensated liver cirrhosis. Decompensation manifests by the occurrence of jaundice, variceal bleeding, ascites, spontaneous bacterial peritonitis, or hepatic encephalopathy. The median survival in patients with compensated cirrhosis is 12 years, but 2 years when decompensated. In addition to the risk of decompensation, patients with liver cirrhosis have an increased risk of developing hepatocellular carcinoma (HCC). Therefore, all patients currently undergo surveillance by ultrasound and laboratory tests every 6 months. Although prognostic scoring systems are developed, it is not possible to predict who will develop decompensated cirrhosis and who will not, let alone who will develop HCC. Aim: To study the long-term outcome of patients with liver cirrhosis, to set up a scientific database and to develop a new prediction model for future decompensation and developing of HCC using existing prognostic scores. To assess the value of the current surveillance program. Methods: In this large prospective study, we collect patient and laboratory data from patients who present with newly diagnosed liver cirrhosis. Data should be easily accessible to identify patients at the highest risk for decompensation or the highest risk for developing HCC. Participating centers are a large Academic Hospital as well as multiple community hospitals in the North Holland metropolitan area. Furthermore, cost-effectiveness of surveillance and quality of life are studied.
Anticipated results: Better prognostic models to predict cirrhosis-related complications like decompensation or HCC. Advantage for the patient: More personalized treatment, whereby high-risk patients can be offered a closer follow-up and low-risk patients can receive a less stringent follow-up regime, resulting in optimizing cost-effectiveness and improvement of quality of life

Keywords

decompensation, hepatocellular carcinoma, liver cirrhosis, prognosis

Other organisations

Dijklander Hospital, Flevo Hospital, Meander Medical Center, Onze Lieve Vrouwe Hospital (OLVG)

Submitter

Organisation Amsterdam University Medical Centers, locations AMC (Amsterdam UMC, AMC)
Name Dr. R.B. (Bart) Takkenberg, MD
E-mail r.b.takkenberg@amsterdamumc.nl