P123 Scan & reveal: liver disease in the community fibroscanning at risk patients in high prevalence areas of north east England

<h3>Introduction</h3> Our trust covers a large geographical area in the North East of England with high rates of liver disease¹ and areas with high socioeconomic deprivation.² To improve access to services we carried out fibroscanning in a community setting for at risk patients from two local GP practices in an area of high socioeconomic deprivation. <h3>Methods</h3> Patients between 18 and 75 years old with a history of alcohol excess, type 2 diabetes and BMI&gt;25, or chronic viral hepatitis without a confirmed history of liver disease were offered a fibroscan. Patients with a BMI&gt;45 and those on the palliative care register were excluded. Fib-4 score calculation was not required beforehand. Patients that did not attend (DNA) were not offered a further appointment. Those with F0, F1 and F2 fibrosis were discharged to the GP with plans for follow up Fib-4 scores as needed. Those with F3 fibrosis were offered another scan in 1 year. Those with F4 disease were offered a clinic appointment for assessment. <h3>Results</h3> 490 fibroscans were carried out between June and December 2024. 87 patients DNA’d (attendance rate 82.3%). 12 patients had inaccurate results and were either rescanned (n=10, not as part of this study) or assessed in clinic if there was a high suspicion of significant liver disease (n=2) leaving 480 patients. 371 (77.3%) of these patients were male, and the mean age was 61.3 years (SD 9.96). The median liver stiffness measurement was 5.8kPa (IQR 4.3 – 7.6). 378 patients (78.8%) of patients had F0/F1 fibrosis, 25 patients (5.2%) had F2 fibrosis, 33 patients (6.4%) had F3 fibrosis, and 46 patients (9.6%) had F4 fibrosis. Of those patients with F4 disease, 6 were already under follow up. The remaining 40 patients were all offered a clinic appointment. 3 patients (7.5%) didn’t attend. Of the remaining 37, 27 were felt to have cirrhosis (72.9% of those who attended clinic, 5.6% of all patients scanned). No patients had grade 2 varices or larger on screening endoscopy and no patients had radiographic or biochemical evidence of hepatocellular carcinoma. <h3>Conclusion</h3> Offering fibroscans in the community is well accepted by patients, demonstrated by a high attendance rate. In this group of patients, the prevalence of cirrhosis was high at 5.6%. We have extended this pilot across the trust with the aim to pick-up more high-risk patients who would benefit from hepatology input. <h3>References</h3> Liver disease profile, April 2024 update – GOV.UK – accessed 01/06/2025. Exploring local income deprivation.