Evidence map›Paper›PMID 42547632›Full record

ArticleSurgical endoscopy2026

Derivation and internal validation of the enhanced liver fibrosis (ELF)-based prediction score for advanced liver fibrosis in obese patients undergoing bariatric surgery.

Saksham Gagal, Brahma Kumar Rath, Washim Firoz Khan, Aditya Baksi, Prasanna Arumugaswamy, Archna Singh, Rajni Yadav, Shalimar, Sandeep Aggarwal, Hemanga Kumar Bhattacharjee

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

10 authors.

Saksham GagalDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Brahma Kumar RathDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Washim Firoz KhanDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India. drwashim@gmail.com.
Aditya BaksiDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Prasanna ArumugaswamyDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Archna SinghDepartment of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Rajni YadavDepartment of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
ShalimarDepartment of Gastroenterology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Sandeep AggarwalDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Hemanga Kumar BhattacharjeeDepartment of Surgical Disciplines, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.

Funding

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6 · The paper itself

Abstract

backgroundLiver fibrosis in obese patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is associated with liver-related complications and mortality. While liver biopsy is the gold standard for assessing fibrosis, it is unsuitable for follow-up. Contemporary non-invasive alternatives for detecting fibrosis are insufficient for accurate surgical risk stratification in bariatric patients. We aimed to develop and internally validate a multivariable prediction score using the Enhanced Liver Fibrosis (ELF) test, liver stiffness measurement (LSM), and routine preoperative laboratory tests and compare its performance against established non-invasive tests (NITs).

methodsThis prospective study was conducted at AIIMS, New Delhi, from January 2022 to August 2025. All patients underwent standard preoperative evaluation and investigations, followed by intraoperative liver biopsy for histological assessment. The best multivariable logistic regression model was derived for advanced fibrosis (≥ F3) and internally validated with 2000 bootstrap resamples.

resultsIn a complete-case analysis of 189 patients, with a mean BMI of 46.3 ± 8.2 kg/m

conclusionThis score provides an accurate, non-invasive alternative to liver biopsy for ruling out advanced fibrosis in patients with obesity undergoing bariatric surgery, with potential utility for longitudinal follow-up. External validation is warranted before clinical implementation.

Indexed as

Bariatric surgeryLiver fibrosisMASLDNon-invasive testsObesity

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PMID42547632

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