Number needed to screen to prevent progression of liver fibrosis to cirrhosis at primary health centers: An experience from Delhi.
Number needed to screen to prevent progression of liver fibrosis to cirrhosis at primary health centers: An experience from Delhi.
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在初级卫生中心进行筛查以防止肝纤维化进展为肝硬化所需的人数：来自德里的经验
DOI：
10.4103/jfmpc.jfmpc_1441_20
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发表时间：
2021-03
影响因子：
1.4
通讯作者：
Sarin SK
中科院分区：
文献类型：
--
作者：
Nagappa B;Ramalingam A;Rastogi A;Dubey S;Thomas SS;Gupta E;Sarin SK
早期诊断一直是慢性肝病患者护理的瓶颈，可以通过使用非侵入性诊断技术进行基于社区的肝纤维化筛查来解决。该研究旨在确定访问城市初级卫生中心（PHC）的成年人中肝纤维化的患病率和预防纤维化进展所需的筛查（NNS）数量。2018年5月至2019年4月，研究人员使用移动筛查车在72个随机选择的初级保健中心进行了一项基于设施的横断面研究。采用预测问卷收集成年患者及护理人员的相关病史。采集静脉血样本进行生化标记，并进行瞬时弹性图测量肝脏硬度（LSM）。以LSM≥6.0 kPa作为检测肝纤维化的截止值。生活方式改变和戒酒分别被视为非酒精性脂肪性肝病（NAFLD）和酒精性肝病（ALD）的干预措施，以计算NNS。研究招募了7624名参与者，平均年龄为46±12岁。约35.5%的参与者患有肝纤维化，3%患有肝硬化。近4%患有ALD， 30%患有NAFLD。预防ALD和NAFLD纤维化进展的NNS分别为12和29。在肥胖、糖尿病和高血压参与者中，NNS最少。三分之一到城市初级保健中心就诊的成年人有明显的肝纤维化。在酒精使用者和其他高危人群中，低NNS可预防纤维化向肝硬化发展，这证实了在这些人群中进行筛查的必要性。
Early diagnosis has been a bottleneck in the care of chronic liver disease patients and can be addressed by Community-based screening for liver fibrosis using non-invasive diagnostic techniques. The study aimed to determine the prevalence of liver fibrosis and the number needed to screen (NNS) to prevent the progression of fibrosis, among adults visiting urban Primary Health Centres (PHC). A facility-based cross-sectional study was conducted from May 2018 to April 2019 in 72 randomly chosen PHCs using a mobile screening van. A pre-tested questionnaire was used to collect relevant history from adult patients and patient attenders. A venous blood sample was collected for biochemical markers and Transient Elastography was also done to measure Liver stiffness (LSM). LSM ≥6.0 kPa was taken as the cut-off for detecting liver fibrosis. Lifestyle modifications and alcohol cessations were considered as interventions for non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) respectively, to calculate NNS. 7624 participants were recruited in the study with a mean age of 46 ± 12 years. Around 35.5% of participants had liver fibrosis and 3% had cirrhosis. Nearly 4% had ALD and 30% had NAFLD. NNS for preventing progression of fibrosis for ALD and NAFLD was 12 and 29 respectively. NNS was least among obese, diabetes and hypertensive participants. One-third of adults visiting urban PHCs had significant liver fibrosis. Low NNS to prevent the progression of fibrosis to cirrhosis among alcohol users and other high-risk groups, substantiates the need for screening among these groups.
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影响因子：
5.1
作者：
Lim, Young-Suk;Kim, W. Ray
通讯作者：
Kim, W. Ray
影响因子：
3.1
作者：
PROPST, A;PROPST, T;VOGEL, W
通讯作者：
VOGEL, W
影响因子：
3.7
作者：
Karlas T;Petroff D;Garnov N;Böhm S;Tenckhoff H;Wittekind C;Wiese M;Schiefke I;Linder N;Schaudinn A;Busse H;Kahn T;Mössner J;Berg T;Tröltzsch M;Keim V;Wiegand J
通讯作者：
Wiegand J
影响因子：
3.7
作者：
Mukherjee, Partha S.;Vishnubhatla, Sreenivas;Chowdhury, Abhijit
通讯作者：
Chowdhury, Abhijit
影响因子：
2.4
作者：
Poynard T;Lebray P;Ingiliz P;Varaut A;Varsat B;Ngo Y;Norha P;Munteanu M;Drane F;Messous D;Bismut FI;Carrau JP;Massard J;Ratziu V;Giordanella JP
通讯作者：
Giordanella JP