Strajhar Petra, Berzigotti Annalisa, Nilius Henning, Nagler Michael, Dufour Jean-François
Master of Public Health, University Basel, University Bern & University Zurich, Zurich, Switzerland.
Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
PLoS One. 2025 Jan 24;20(1):e0317629. doi: 10.1371/journal.pone.0317629. eCollection 2025.
BACKGROUND & AIMS: Chronic liver diseases pose a serious public health issue. Identifying patients at risk for advanced liver fibrosis is crucial for early intervention. The Fibrosis-4 score (FIB-4), a simple non-invasive test, classifies patients into three risk groups for advanced fibrosis. This study aimed to estimate the prevalence of patients at risk for advanced hepatic fibrosis at a Swiss tertiary care hospital by calculating the FIB-4 score in routine blood analysis.
A retrospective study was conducted using data from 36,360 patients who visited outpatient clinics at eight main clinics of the University Hospital Bern in Switzerland. The data collection period ran from January 1st to December 31st, 2022. Patients attending the hepatology outpatient clinic were excluded. We then calculated the overall and clinic-specific prevalence of patients falling into the high risk category for advanced fibrosis according to FIB-4.
Among the 36,360 patients, 26,245 (72.2%) had a low risk of advanced fibrosis (FIB-4 <1.3), whereas 3913 (10.8%) and 2597 (7.1%) patients were flagged to have a high risk of advanced fibrosis (FIB-4 >2.67 and FIB-4 >3.25 respectively). Geriatrics and Cardiology had the highest proportions of patients at risk for advanced fibrosis over all clinics.
This study demonstrates a high prevalence of high FIB-4 score in a Swiss tertiary care hospital. The implementation of the automatically generated FIB-4 score in daily practice, not only in primary care, but also within tertiary care hospitals, could be crucial for early identification of outpatients at high risk of advanced liver fibrosis requiring further hepatological investigations.
慢性肝病是一个严重的公共卫生问题。识别有进展性肝纤维化风险的患者对于早期干预至关重要。Fibrosis-4评分（FIB-4）是一种简单的非侵入性检测方法，可将患者分为进展性纤维化的三个风险组。本研究旨在通过在常规血液分析中计算FIB-4评分，估计瑞士一家三级护理医院中进展性肝纤维化风险患者的患病率。
采用瑞士伯尔尼大学医院八个主要门诊的36360例门诊患者的数据进行回顾性研究。数据收集期为2022年1月1日至12月31日。排除肝病门诊患者。然后我们根据FIB-4计算了进展性纤维化高风险类别患者的总体患病率和各门诊特定患病率。
在36360例患者中，26245例（72.2%）进展性纤维化风险低（FIB-4<1.3），而3913例（10.8%）和2597例（7.1%）患者被标记为进展性纤维化高风险（分别为FIB-4>2.67和FIB-4>3.25）。在所有门诊中，老年医学科和心脏病学科有进展性纤维化风险的患者比例最高。
本研究表明，在瑞士一家三级护理医院中，FIB-4评分高的患病率很高。在日常实践中实施自动生成的FIB-4评分，不仅在初级保健中，而且在三级护理医院中，对于早期识别有进展性肝纤维化高风险、需要进一步肝病检查的门诊患者可能至关重要。
