{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:58:51Z","timestamp":1790477931799,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>A combination of platelet and elastography (PE criteria) was proposed to identify compensated advanced chronic liver disease (cACLD) patients at risk of liver decompensation. We aim to validate and refine PE criteria by developing a new predictive score to predict decompensation in Asian cACLD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An international cohort of 633 cACLD patients with liver stiffness measurement (LSM) and esophagogastroduodenoscopy performed were included. We validated PE criteria to predict first liver decompensation using competing risk analysis, with death and hepatocellular carcinoma as competing events. We developed a predictive model using proportional subdistribution hazard regression. Prognostic accuracy was compared with the model of end\u2010stage liver disease (MELD), albumin\u2013bilirubin (ALBI), and ALBI\u2013FIB\u20104 score using time\u2010dependent area under operative characteristic curve (tAUC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients developed decompensation over the median follow\u2010up of 39\u00a0months. Favorable Baveno VI status ruled out cACLD patients at risk of liver decompensation. LSM\u00a0&gt;\u00a025\u00a0kPa was suboptimal to predict cACLD patients who will develop liver decompensation. We developed CHESS\u2010ALARM score by incorporating age, platelet, and gender into LSM. CHESS\u2010ALARM score (tAUC\u00a0=\u00a00.86, 95% confidence interval [CI]: 0.79\u20130.94) has significantly higher accuracy than MELD (tAUC: 0.61), ALBI (tAUC: 0.62), ALBI\u2013FIB\u20104 (tAUC: 0.70), and LSM\u00a0&gt;\u00a025\u00a0kPa (tAUC: 0.54) to predict liver decompensation at 5\u00a0years (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05 for all). Patients with CHESS\u2010ALARM score\u00a0\u2265\u00a0\u22120.37 had an 11\u2010fold higher risk of decompensation (subdistribution hazard ratio\u00a0=\u00a011.2, 95% CI: 5.1\u201324.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CHESS\u2010ALARM score can be readily incorporated into clinical practice of cACLD patients to estimate individual risk of liver decompensation; however, more data are required in morbidly obese cACLD patients of nonviral etiology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15819","type":"journal-article","created":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T01:19:16Z","timestamp":1646615956000},"page":"1043-1051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["CHESS\u2010ALARM score to stratify decompensation risk in compensated advanced chronic liver disease patients: An international multicenter study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0727-1183","authenticated-orcid":false,"given":"Yu Jun","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital  Singapore"},{"name":"Duke\u2010NUS Academic Medical Program SingHealth  Singapore"},{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0100-417X","authenticated-orcid":false,"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tianjin Second People's Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Liu","sequence":"additional","affiliation":[{"name":"CHESS Center, Institute of Portal Hypertension The First Hospital of Lanzhou University  Lanzhou 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