Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Sep;62(5):526-535.
doi: 10.1111/apt.70215. Epub 2025 Jun 10.

Predicting Hepatic Decompensation in Patients With Metabolic Dysfunction Associated Steatotic Liver Disease-Related Cirrhosis: The ABID-LSM Model

Luis Calzadilla Bertot  1   2 , Anna Sòria  3 , Alba Jimenez-Masip  4 , Isabel Serra  5 , Teresa Broquetas  6 , Mercedes Vergara  7 , Adrià Rodriguez  8 , Carles Aracil  9 , Cautar El Maimouni  3 , Sergio Muñoz-Martinez  4 , Jose A Carrión  6 , Albert Pardo  8 , Juan M Pericàs  4 , Isabel Graupera  3 , Leon A Adams  1   2
Affiliations
Multicenter Study

Predicting Hepatic Decompensation in Patients With Metabolic Dysfunction Associated Steatotic Liver Disease-Related Cirrhosis: The ABID-LSM Model

Luis Calzadilla Bertot et al. Aliment Pharmacol Ther. 2025 Sep.

Abstract

Background & aims: Predicting the risk of hepatic decompensation guides prognostication and therapy; however, it is challenging in patients with cirrhosis due to metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to improve a previously developed predictive tool of hepatic decompensation in MASLD cirrhosis (ABIDE) by incorporating liver stiffness measurement (LSM).

Methods: A multi-centre retrospective cohort of patients with compensated cirrhosis due to MASLD was identified, with decompensation incidence assessed using competing risk regression. The prognostic accuracy of a modified ABIDE model incorporating LSM (ABID-LSM) was assessed using time-dependent AUC (tAUC) and compared with other predictive models.

Results: Out of 388 patients, 273 (70.4%) had available LSM. Hepatic decompensation occurred in 54 (20%) patients during follow-up (median 31 months, range: 20-60). The predictive accuracy at 5 years of ABID-LSM (tAUC 0.80) was better than ABIDE (tAUC 0.75, p = 0.03) and LSM (tAUC 0.63, p < 0.001). The ABID-LSM model calibrated well (slope 0.99) with excellent overall performance (Integrated Brier Score 0.15). A cut-off of 8.1 separated those at high and low risk of hepatic decompensation at 5 years (24% vs. 5%, respectively, sHR = 4.8, p < 0.001). The ABID-LSM model had better predictive ability at 5 years than ALBI, FIB-4, NAFLD Decompensation Risk Score and ANTICIPATE models (all p < 0.001) as well as hepatic vein pressure gradient measurement (tAUC 0.78 vs. 0.71, p < 0.001, n = 60).

Conclusions: The ABID-LSM model has greater accuracy in predicting hepatic decompensation in patients with cirrhosis due to MASLD than existing predictive models. If externally validated, ABID-LSM may identify those who benefit from pharmacotherapy and close monitoring.

Keywords: fatty liver; liver cirrhosis; liver related events; predictive model; prognosis.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Flow chart and outcomes of enrolled patients.
FIGURE 2
FIGURE 2
Cumulative incidence of hepatic decompensation in patients with MASLD cirrhosis (n = 273).
FIGURE 3
FIGURE 3
Hepatic decompensation in MASLD cirrhosis. Stratification by ABID‐LSM score categories (n = 273). Cumulative incidence curve indicates predictions calculated by competing‐risks regression.
See this image and copyright information in PMC

References

    1. Younossi Z. M., Golabi P., Paik J. M., Henry A., Van Dongen C., and Henry L., “The Global Epidemiology of Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH): A Systematic Review,” Hepatology 77, no. 4 (2023): 1335–1347. - PMC - PubMed
    1. Ferretti S. and Barreyro F. J., “Worldwide Increasing Prevalence of Non‐Alcoholic Steatohepatitis as an Indication of Liver Transplantation: Epidemiological View and Implications,” Current Hepatology Reports 23, no. 1 (2024): 193–203.
    1. Younossi Z. M., Stepanova M., Al Shabeeb R., et al., “The Changing Epidemiology of Adult Liver Transplantation in the United States in 2013–2022: The Dominance of Metabolic Dysfunction–Associated Steatotic Liver Disease and Alcohol‐Associated Liver Disease,” Hepatology Communications 8, no. 1 (2024): e0352. - PMC - PubMed
    1. Estes C., Anstee Q. M., Arias‐Loste M. T., et al., “Modeling Nafld Disease Burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the Period 2016–2030,” Journal of Hepatology 69, no. 4 (2018): 896–904. - PubMed
    1. Hagström H., Vessby J., Ekstedt M., and Shang Y., “99% of Patients With NAFLD Meet MASLD Criteria and Natural History Is Therefore Identical,” Journal of Hepatology 80, no. 2 (2024): e76–e77. - PubMed

Publication types

LinkOut - more resources