Photo Credit: Cristian Storto Fotografia

Fecal calprotectin was independently proportional to the risk for adverse outcomes, defined as death or liver transplant, in advanced chronic liver disease.

Fecal calprotectin (F-CAL) values were independently proportional to the risk for adverse outcomes in hospitalized patients with advanced chronic liver disease (ACLD), according to results of a study with more than 250 patients.

Findings were published in United European Gastroenterology Journal.

Lubomir Skladany, MD, PhD, and colleagues examined the effectiveness of F-CAL testing in ACLD for predicting adverse outcomes, defined as death from any cause or liver transplantation within the first 180 days (study group) or 120 days (control group), and for refining prognostic stratification. The researchers used the RH7 cirrhosis registry data for compiling a group of consecutive hospitalized patients and a control group, obtaining data on disease phenotype, demographics, anthropometrics, prognostic indices, and medication use.

Value of F-CAL Seen in Patients, Validated in Controls

The researchers included 263 cases in the study group (median age, 57.2) and 108 cases in the control group.

Highly prevalent etiologies in the study group included alcohol use (72.2%) and metabolic dysfunction-associated steatotic liver disease (9.1%). The median F-CAL in this patient group was 3.92 times the upper limit of normal (ULN).

The adjusted Cox model confirmed that F-CAL (HR=1.05; P<0.001) and F-CAL terciles (HR=1.413; P=0.009) represented independent predictors for adverse outcomes. F-CAL terciles had higher predictive accuracy in patients with CLIF-C-AD scores of less than 50 (HR=2.49; P=0.013) and Child-Pugh-Turcotte stages A and B (HR=1.706; P=0.025), in whom high F-CAL (cutoff: >11×ULN) could identify patients at two to three times greater risk for adverse outcomes.

Dr. Skladany and colleagues also validated the approach in the control group.

F-CAL An Independent Predictor of Adverse Outcomes

Together, the findings show that F-CAL represents an independent predictor of adverse outcomes in patients with ACLD, according to the researchers and they noted that the probability of adverse outcomes “is directly proportional” to F-CAL measurements.

“The results of our study provide more evidence for the use of F-CAL in clinical care for [patients with ACLD],” Dr. Skladany and colleagues wrote. “However, external validation is warranted, and the exact mechanisms of calprotectin release and its association with [bacterial translocation] are yet to be deciphered.”