{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:03:20Z","timestamp":1767773000829,"version":"build-2065373602"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T00:00:00Z","timestamp":1580169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intestinal failure\u2013associated liver disease (IFALD) is one of the leading complications in type III intestinal failure (IF). Early recognition of liver\u2010fibrosis development in IFALD is crucial to the development of strategies aimed at reducing the risk of complications secondary to IFALD. Our aim was to identify patients with advanced fibrosis using a noninvasive index and to study the risk factors for fibrosis development in the Sustain registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Sustain registry, patients requiring &gt;3 months of parenteral nutrition (PN) support were identified. The presence or absence of advanced fibrosis was identified using the Fibrosis\u20104 (FIB\u20104) index. Risk factors for the presence of a high FIB\u20104 score were identified using univariable logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred seventy\u2010one adult patients were included. Sixty\u2010three patients (23.2%) were at risk for advanced fibrosis based on the FIB4\u2010index. Risk factors for advanced fibrosis included short\u2010bowel syndrome (odds ratios [ORs]: 1.84; 95% confidence interval [CI], 1.03\u20133.28), receipt of PN for &gt;1 year (OR: 2.6; 95% CI, 1.46\u20134.64), receipt of PN for &gt;5 years (OR: 3.05; 95% CI, 1.67\u20135.59), and days of lipid emulsion use (OR: 1.11; 95% CI, 1\u20131.24). Small\u2010intestine\u2013remnant length was inversely associated with advanced fibrosis (OR: 0.97, 95% CI, 0.95\u20130.99).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Advanced fibrosis, as guided by FIB\u20104 index, is associated with known risk factors for IFALD. Therefore, the FIB\u20104 index is potentially a useful noninvasive tool for identification of individuals at risk for fibrosis in IFALD. Further studies utilizing a gold\u2010standard fibrosis assessment will be required to validate these results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.1758","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T07:02:27Z","timestamp":1580194947000},"page":"1285-1290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of Fibrosis in Intestinal Failure\u2013Associated Liver Disease in the Sustain Registry"],"prefix":"10.1002","volume":"44","author":[{"given":"Jennifer","family":"Wang","sequence":"first","affiliation":[{"name":"Section of Gastroenterology Hepatology and Nutrition Department of Internal Medicine University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Obinnaya","family":"Wamuo","sequence":"additional","affiliation":[{"name":"Maclean Center for Clinical Medical Ethics University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2864-1670","authenticated-orcid":false,"given":"Dejan","family":"Micic","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology Hepatology and Nutrition Department of Internal Medicine University of Chicago Medicine  Chicago Illinois 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