Steatotic Liver Disease Risk Scores for Predicting Cirrhosis and Hepatocellular Carcinoma: A Comprehensive Clinical Review

Highlights

• The SAFE score shows the greatest net clinical benefit in predicting 10-year cirrhosis risk among patients with noncirrhotic steatotic liver disease (SLD).
• FIB-4 and APRI scores also demonstrate strong discrimination for cirrhosis, but SAFE outperforms others in net benefit analyses.
• Risk scores for hepatocellular carcinoma (HCC) show limited clinical utility for surveillance decisions in noncirrhotic SLD.
• Non-invasive fibrosis scoring and machine-learning models are emerging tools supplementing traditional risk scores, aiding early disease stratification.

Background