ArticleJournal of general internal medicine2022
The Association of Fibrosis-4 Index Scores with Severe Liver Outcomes in Primary Care.
Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.Hepatology international · 2025Guideline
- Association of Semaglutide Treatment With Liver Cirrhosis and Hepatocellular Carcinoma in Type 2 Diabetes: A Population-Based Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Discordant FIB-4 and liver stiffness in metabolic dysfunction-associated steatotic liver disease as related to histology and liver-related events in a global cohort: Editorial on "Histological severity and hepatic outcomes in patients with metabolic dysfunction-associated steatotic liver disease and discrepant FIB-4 and liver stiffness measurement".Clinical and molecular hepatology · 2026Article
- Neuroimmune Correlates of HIV and Marijuana Use: Peripheral Biomarkers and Cognitive Function.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2026Article
- Albuminuria and Metabolic Dysfunction-Associated Steatotic Liver Disease with Advanced Fibrosis in Primary Care.Metabolic syndrome and related disorders · 2026Article
- Prevalence of MASLD and Fibrosis Risk in Turkish Adults with Cardiometabolic Risk Factors: A Nationwide Multicenter Study (DAHUDER MASLD Study).Journal of clinical medicine · 2025Article
- Association between fibrosis-4 index and coronary heart disease: a population-based study.BMC cardiovascular disorders · 2025Article
- Elevated fibrosis‑4 index is associated with 30-day mortality in adult hemophagocytic lymphohistiocytosis patients.Annals of hematology · 2025Article
- Prevalence of advanced liver fibrosis in the general population of the Paris region according to FIB-4 score and liver risk score.BMC gastroenterology · 2025Article
- Association between fibrosis-4 index (FIB-4) and gallstones: an analysis of the NHANES 2017-2020 cross-sectional study.BMC gastroenterology · 2025Article
- Association between liver fibrosis's noninvasive scores and retinal imaging changes: insights from NHANES.Journal of health, population, and nutrition · 2025Article
- Estimating the prevalence of adults at risk for advanced hepatic fibrosis using FIB-4 in a Swiss tertiary care hospital.PloS one · 2025Article
- Baseline liver fibrosis-4 score correlates to the progression of anxiety and cognitive impairment in patients with Parkinson's disease.Frontiers in aging neuroscience · 2025Article
- Association of Index and Changes in Fibrosis-4 Score With Outcomes in Metabolic Dysfunction-Associated Steatohepatitis.Gastro hep advances · 2025Article
- Association between fibrosis-4 index and cognitive impairment in elderly patients with hypertension: A cross-sectional study.Journal of clinical hypertension (Greenwich, Conn.) · 2024Article
- Statin prescriptions and progression of advanced fibrosis risk in primary care patients with MASLD.BMJ open gastroenterology · 2024Article
- An Electronic Health Record Model for Predicting Risk of Hepatic Fibrosis in Primary Care Patients.Digestive diseases and sciences · 2024Article
- Time‑dependent ROC curve analysis to determine the predictive capacity of seven clinical scales for mortality in patients with COVID‑19: Study of a hospital cohort with very high mortality.Biomedical reports · 2024Article
- Real-World Primary Care Data Comparing ALT and FIB-4 in Predicting Future Severe Liver Disease Outcomes.Journal of general internal medicine · 2023Article
- FIB-4 and incident severe liver outcomes in patients with undiagnosed chronic liver disease: A Fine-Gray competing risk analysis.Liver international : official journal of the International Association for the Study of the Liver · 2023Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe Fibrosis-4 Index (FIB-4)non-invasively assesses fibrosis risk in chronic liver disease (CLD), but underdiagnosis limits FIB-4's application in primary care.
objectiveTo evaluate the association of FIB-4 risk with hazard of severe liver outcomes in primary care patients with and without diagnosed CLD.
designRetrospective cohort study of primary care data from 2007 to 2018.
participantsAdult patients with qualifying aminotransferase and platelet count results were included and a single FIB-4 score was calculated for each patient using the first of these values. Patients with a CLD diagnosis or outcome prior to their FIB-4 score were excluded. MEASURES: FIB-4 advanced fibrosis risk categorization (low, indeterminate, and high) was the primary predictor variable. Patients were followed from FIB-4 score to a severe liver outcome, a composite of cirrhosis, liver transplantation, and hepatocellular carcinoma. We analyzed the association of FIB-4 risk categories with hazard risk of a severe liver outcome using stratified Cox regression models, stratifying patients by known CLD. KEY
resultsA total of 20,556 patients were followed for a mean 2,978 days (SD 1,201 days), and 4% of patients experienced a severe liver outcome. Of patients with low-, indeterminate-, and high-risk FIB-4 scores, 2%, 4%, and 20% suffered a severe liver outcome, respectively. In the overall adjusted model, high-risk FIB-4 scores were associated with hazard of severe liver disease (HR 6.64; 95% CI 5.58-7.90). High-risk FIB-4 scores were associated with severe liver outcomes for patients with known NAFLD (HR 7.32; 95% CI 3.44-15.58), other liver disease (HR 11.39; 95% CI 8.53-15.20), and no known CLD (HR 4.05; 95% CI 3.10-5.28).
conclusionsHigh-risk FIB-4 scores were strongly associated with risk of severe liver outcomes in patients with and without known CLD. Comprehensive FIB-4 application in primary care may signal silently advancing liver fibrosis.
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