{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:11:54Z","timestamp":1791364314899,"version":"4.3.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004853","name":"Chinese University of Hong Kong","doi-asserted-by":"publisher","award":["2021.027"],"award-info":[{"award-number":["2021.027"]}],"id":[{"id":"10.13039\/501100004853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Baveno VII was proposed for non\u2010invasive identification of clinically significant portal hypertension. However, a substantial proportion of patients is classified in the grey zone (<jats:italic>i.e<\/jats:italic>., liver stiffness 15\u201324.9\u2009kPa and\/or platelet count &lt;150\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the risk and predictors of hepatic decompensation in patients in the grey zone, and to determine the prognostic role of spleen stiffness measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included prospective cohorts (from Hong Kong, Korea and France) of patients who had undergone transient elastography examination for chronic liver disease. We estimated risk of hepatic decompensation using competing risk regression with hepatocellular carcinoma and non\u2010liver\u2010related death as competing events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 2763 patients with compensated advanced chronic liver disease (cACLD). There were 1243 (44.9%) and 536 (19.4%) patients in the Baveno VII grey zone and high\u2010risk groups, respectively. The cumulative incidence of decompensation at 5\u2009years was significantly different among low\u2010risk (0.6% [95% CI: 0.2%\u20131.3%]), grey zone 4.2% (95% CI: 3.1%\u20135.4%) and high\u2010risk groups (11.4% [95% CI: 8.7%\u201314.6%]). By competing risk analysis, aetiology of liver disease (alcohol\u2010related liver disease), albumin\u2013bilirubin score and alkaline phosphatase level were independently associated with decompensation among patients in the grey zone. The combination of Baveno VII and spleen stiffness significantly reduced patients classified into grey zone (12.8% in cACLD patients), while maintaining high discrimination of decompensation in low\u2010 and high\u2010risk groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients in grey zone of Baveno VII criteria remain at high risk of hepatic decompensation. Clinical risk factors and spleen stiffness can further stratify the risk in such patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17699","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T10:39:03Z","timestamp":1693391943000},"page":"920-928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Risk and predictors of hepatic decompensation in grey zone patients by the Baveno VII criteria: A competing risk analysis"],"prefix":"10.1111","volume":"58","author":[{"given":"Huapeng","family":"Lin","sequence":"first","affiliation":[{"name":"Medical Data Analytics Centre, Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong Hong Kong"},{"name":"State Key Laboratory of Digestive Disease The Chinese University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy Che\u2010To","family":"Lai","sequence":"additional","affiliation":[{"name":"Medical Data Analytics Centre, Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong Hong Kong"},{"name":"State Key Laboratory of Digestive Disease The Chinese University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace Lai\u2010Hung","family":"Wong","sequence":"additional","affiliation":[{"name":"Medical Data Analytics Centre, Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong Hong Kong"},{"name":"State Key Laboratory of Digestive Disease The Chinese University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad\u00e8le","family":"Delamarre","sequence":"additional","affiliation":[{"name":"Hepatology Unit H\u00f4pital Haut L\u00e9v\u00eaque, Bordeaux University Hospital  Bordeaux France"},{"name":"INSERM U1312, Bordeaux University  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