Performance of a calculator for diagnosing the cause of liver damage

Introduction/Objective. Making a calculator that would recognize patterns of abnormal liver function tests and link them to the most probable etiology could help clinicians in their initial orientation towards a definitive diagnosis in patients with liver damage. The aim of our study was to design, construct, and validate a calculator that based on a pattern of abnormalities in liver function tests of a patient with liver damage would propose the most probable etiology. Methods. Patterns of abnormal liver function tests for certain etiology of liver damage were extracted from distributions of actual values taken from reports in medical literature about patients whose etiology of liver damage was proven by reliable diagnostic tests. After setting up the calculator with the patterns extracted, its diagnostic value was checked under real-life conditions, on a sample of patients with liver damage whose etiology was established by the gold standard of diagnostics (biopsy or else). The calculator validation study was carried out at the Military Medical Academy in Belgrade during a two-year period (2015?2016). Results. For all tested diagnoses, the calculator demonstrated a highly significant difference between the area under the receiver-operator curves? values and the value of 0.5 (p < 0.001), and high level of sensitivity (more than 90%, except for the model for chronic hepatitis) as well as relatively high specificity (more than 75%) were noted, indicating good ability of the calculator to detect etiology of liver damage. Conclusion. New calculators showed satisfactory sensitivity and specificity for revealing major liver damage etiologies.

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The role of pre-surgical INR testing in dental patients with liver diseases

Journal of Global Oral Health ◽

10.25259/jgoh_24_2020 ◽

2020 ◽

Vol 3 ◽

pp. 89-93

Author(s):

Behzad Mostoufi ◽

Allison Clark ◽

Nicholas Wilken ◽

John Sands ◽

Timothy F. Meiller ◽

...

Keyword(s):

Liver Function ◽

Liver Diseases ◽

Maxillofacial Surgery ◽

Bleeding Risk ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Oral And Maxillofacial Surgery ◽

Oral Surgical Procedures ◽

Function Tests ◽

Significant Difference

Objectives: The aim of this study was to evaluate the validity of international normalized ratio (INR) in patients with liver diseases or abnormal liver function tests as related to bleeding risk in dental procedures. Materials and Methods: From July 2008 to January 2019, the INR of 187 patients with liver diseases who underwent oral surgical procedures at the Department of Oral and Maxillofacial Surgery Clinic, University of Maryland School of Dentistry was collected and compared with normal value. Patients who were taking anticoagulants were excluded from the data pool. Results: The compiled INR for the 187 patients (M/F = 122/65) with mean age of 47 years (range: 22–77) was 1.126, with a median and mode of 1.1. The standard deviation was 0.17. The range for the INR values was 0.7 (n = 1) to 1.7 (n = 1). Conclusion: In the present study, there was no significant difference between the INR of patients with liver diseases or abnormal liver function tests and normal INR value. This supports the belief that pre-operative INR testing is not a dependable marker to assess bleeding risk in patients with chronic liver diseases who are not taking Vitamin K antagonist anticoagulants.

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Alpha 1 Anti Trypsin Levels in Asymptomatic Patients with Abnormal Liver Function Tests

Endoscopy ◽

10.1055/s-2006-956876 ◽

2006 ◽

Vol 38 (11) ◽

Author(s):

BJ Egan ◽

S Sarwar ◽

M Anwar ◽

C O'Morain ◽

B Ryan

Keyword(s):

Liver Function ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Function Tests ◽

Asymptomatic Patients

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Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

Journal of Clinical Medicine ◽

10.3390/jcm10081730 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1730

Author(s):

Hiroshi Miyama ◽

Yasuyuki Shiraishi ◽

Shun Kohsaka ◽

Ayumi Goda ◽

Yosuke Nishihata ◽

...

Keyword(s):

Heart Failure ◽

Liver Function ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Adverse Outcomes ◽

Long Term Outcomes ◽

Function Tests ◽

Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

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