肝硬化是全球死亡的主要原因之一。肝硬化在长期无症状的纤维化进展期后发展，诊断常在主要并发症或癌症出现时才进行。当前几乎没有可靠的工具用于及时识别患有肝硬化风险的个体，以实现早期干预。我们旨在开发一种新的评分来识别有肝相关结局风险的个体。我们从六个国家的国际前瞻性队列中获取了未患有已知肝脏疾病的普通人群个体，他们经历了肝纤维化评估（采用瞬时弹性断层成像法）。该评分包括年龄、性别和六个标准化验指标。我们根据LiverRisk评分的选定截断值（6、10和15）创建了四个组别：最低风险、低风险、中等风险和高风险。模型的区分力和校准性在来自普通人群的两个前瞻性队列中进行了外部验证。此外，我们确定了该评分在预测未患有已知肝脏疾病的参与者的肝相关结局的预后价值，随访中位数为12年（英国生物储存银行队列）。我们纳入了14,726名参与者：识别队列有6,357名（43.2%），第一个外部验证队列有4,370名（29.7%），第二个外部验证队列有3,999名（27.2%）。该评分在开发和外部验证队列中准确预测了肝硬度，并且优于常规纤维化血清生物标志物，通过受试者工作特征曲线下面积（AUC）测得（0.83 [95% CI 0.78-0.89]），而FIB-4指数则为0.68 [0.61-0.75]，它衡量了10 kPa时的纤维化状况。该评分有效地识别了有肝相关死亡风险、肝相关住院和肝癌风险的个体，从而可以根据肝相关结局风险将其分层到不同的风险组别。高风险组与最低风险组相比，肝相关死亡风险比为471 (95% CI 347-641)，评分对10年肝相关死亡的预测的整体AUC为0.90 (0.88-0.91)，而FIB-4为0.84 (0.82-0.86)。LiverRisk评分基于简单参数，能够预测普通人群中的肝纤维化以及肝相关结局的未来发展。该评分可以根据肝脏风险对个体进行分层，从而指导预防性护理。无。版权所有© 2023 Elsevier Ltd. 保留所有权利。

Liver cirrhosis is a major cause of death worldwide. Cirrhosis develops after a long asymptomatic period of fibrosis progression, with the diagnosis frequently occurring late, when major complications or cancer develop. Few reliable tools exist for timely identification of individuals at risk of cirrhosis to allow for early intervention. We aimed to develop a novel score to identify individuals at risk for future liver-related outcomes.We derived the LiverRisk score from an international prospective cohort of individuals from six countries without known liver disease from the general population, who underwent liver fibrosis assessment by transient elastography. The score included age, sex, and six standard laboratory variables. We created four groups: minimal risk, low risk, medium risk, and high risk according to selected cutoff values of the LiverRisk score (6, 10, and 15). The model's discriminatory accuracy and calibration were externally validated in two prospective cohorts from the general population. Moreover, we ascertained the prognostic value of the score in the prediction of liver-related outcomes in participants without known liver disease with median follow-up of 12 years (UK Biobank cohort).We included 14 726 participants: 6357 (43·2%) in the derivation cohort, 4370 (29·7%) in the first external validation cohort, and 3999 (27·2%) in the second external validation cohort. The score accurately predicted liver stiffness in the development and external validation cohorts, and was superior to conventional serum biomarkers of fibrosis, as measured by area under the receiver-operating characteristics curve (AUC; 0·83 [95% CI [0·78-0·89]) versus the fibrosis-4 index (FIB-4; 0·68 [0·61-0·75] at 10 kPa). The score was effective in identifying individuals at risk of liver-related mortality, liver-related hospitalisation, and liver cancer, thereby allowing stratification to different risk groups for liver-related outcomes. The hazard ratio for liver-related mortality in the high-risk group was 471 (95% CI 347-641) compared with the minimal risk group, and the overall AUC of the score in predicting 10-year liver-related mortality was 0·90 (0·88-0·91) versus 0.84 (0·82-0·86) for FIB-4.The LiverRisk score, based on simple parameters, predicted liver fibrosis and future development of liver-related outcomes in the general population. The score might allow for stratification of individuals according to liver risk and thus guide preventive care.None.Copyright © 2023 Elsevier Ltd. All rights reserved.