title: Liver stiffness and 30-day mortality in a cohort of patients admitted to hospital.
abstract: BACKGROUND
  Transient elastography (TE) is a new noninvasive method to assess the degree of liver fibrosis by measuring liver stiffness. The objective of this study was to determine whether increased liver stiffness in patients admitted to medical wards was associated with increased 30-day mortality.
  
  
  METHODS
  A prospective cohort study at the medical admissions ward at Odense University Hospital, Denmark, covering a population of 300 000 inhabitants. Consecutive patients ≥ 18 years of age were examined by TE (Fibroscan) at admission. Outcome measure was 30-day mortality.
  
  
  RESULTS
  Among 568 patients admitted during 24 days, 289 (50·8%) were included in the study, 212 (73·4%) with valid TE measurement. Increased liver stiffness (TE value > 8 kPa) was found in 22·6% (48/212). This was independently associated with cirrhosis of the liver (P < 0·001) and congestive heart failure (CHF) (P < 0·001). The estimated prevalence of cirrhosis was 7% (95% CI 4-11%). The 30-day mortality among patients with TE value > 8 kPa was 20·8% (10/48, 95%CI 10·5-35·0%) compared to patients with TE value ≤ 8 kPa 3·7% (6/164, 95%CI 1·3-7·8%) (P < 0·001), and TE value > 8 kPa was an independent predictor of death.
  
  
  CONCLUSIONS
  Elevated TE value at admission is associated with increased mortality, cirrhosis of the liver and CHF. This information may potentially be used to improve the outcome of high-risk patients admitted to hospital.
authors.affiliation: Departments of Infectious Diseases, Odense University Hospital, Odense, Denmark.
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Lindvig
authors.forename: Belinda K
authors.initials: BK
authors.lastname: Mössner
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.forename: Søren T
authors.initials: ST
authors.lastname: Lillevang
authors.forename: Peer B
authors.initials: PB
authors.lastname: Christensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003718:Denmark; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors