Liver stiffness predicts progression to liver‐related events in patients with chronic liver disease – A cohort study of 14 414 patients

Background & Aims Liver stiffness measurement (LSM) by vibration‐controlled transient elastography (VCTE) is a non‐invasive diagnostic biomarker of liver fibrosis. It is uncertain if LSM can predict risk for future liver‐related outcomes in large, heterogenous populations. Methods This Swedish multi‐centre cohort study included patients (n = 14 414) from 16 sites who underwent LSM by VCTE between 2008 and 2020. Outcomes were ascertained from national registers. We investigated progression to cirrhosis with portal hypertension or hepatocellular carcinoma (HCC), separately. Cox regression was used to obtain hazard ratios (HRs). Harrel's C‐index was used to measure discrimination of VCTE. Results Included patients had a median age of 46 (interquartile range 34–57), median LSM of 5.9 kPa (4.6–8.0), 59% were male, and the majority had hepatitis C (50.1%). During a median follow‐up of 5.9 (4.3–8.0) years, 402 patients (2.7%) developed cirrhosis with portal hypertension. In patients with an LSM ≥25 kPa, 28.7% developed cirrhosis with portal hypertension within 5 years of follow‐up, while only .6% of patients with an LSM