NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score

Why Use

Patients with nonalcoholic fatty liver disease (NAFLD) and advanced liver cirrhosis are high risk for progression to end-stage liver disease. Patients with known liver fibrosis should have their fibrosis trended over time to evaluate for progression or stabilization.

When to Use

Patients who have been identified to have NAFLD.

Formula

Pearls / Pitfalls

Nonalcoholic fatty liver disease (NAFLD) is now the leading cause of chronic liver disease in the world. Many NAFLD patients will have little progression in their disease, however a subset will progress to liver fibrosis and cirrhosis. Patients studied to develop this score were screened for other causes of liver disease and were specifically evaluated closely for concomitant alcohol. Patients with already-decompensated liver disease by clinical or imaging evidence were also excluded. Patients with NAFLD should have their fibrosis scores trended over time to evaluate for progression or stabilization. The NAFLD can reduce liver biopsies in those patients predicted to have a low risk of fibrosis by their score: “a liver biopsy to determine severity of fibrosis would be required in only 25% of patients with NAFLD, that is, those identified as ‘indeterminate’.”

Advice

Depending on score and local prevalence of advanced fibrosis, the score can be used to reliably predict (with high 80-low 90% accuracy) which patients are unlikely to have cellular evidence of fibrosis on biopsy.

More Information

NAFLD Score Correlated Fibrosis Severity < -1.455 F0-F2 -1.455 – 0.675 Indeterminant score > 0.675 F3-F4 Fibrosis Severity Scale F0 = no fibrosis F1 = mild fibrosis F2 = moderate fibrosis F3 = severe fibrosis F4 = cirrhosis