Characterization of an At-Risk Population for Nonalcoholic Fatty Liver Disease (NAFLD) in a Primary Care Setting Along the U.S.-Mexico Border.
Lindsay Spitz, Stefan Saadiq, Navkiran K Shokar and 4 others
PMID 39189342WHAT IT FOUND
Border primary care records showed 83.8% of selected patients met criteria for NAFLD screening risk.
Yet only 21.7% of indeterminate-risk patients had follow-up imaging, and 35.7% of high-risk patients were not referred.
Key findings
01In the analysed 223 records, 83.8% met pathway criteria for NAFLD risk.
02FIB-4 scores placed 149 patients at low risk, 60 at indeterminate risk, and 14 at high risk.
03Only 21.7% of indeterminate-risk patients had follow-up imaging, and 35.7% of high-risk patients did not receive a referral.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was chosen because patients already had at least one NAFLD risk factor, so the high risk rate cannot be read as community prevalence. The data came from one clinic and may not represent all El Paso residents. Missing laboratory values removed 101 records from the final analysis. Waist circumference was not recorded, so some patients with obesity and another risk factor may have been undercounted. Liver elastography was unavailable, so the pathway could not fully resolve indeterminate risk. Referral and follow-up care were not consistently recorded, so the study cannot say what happened after screening. It is a retrospective record review, not a test of whether the pathway changes patient outcomes.
The easy way to misread this
Do not read the 83.8% figure as true NAFLD prevalence in the border population. The records were selected because patients already had at least one NAFLD risk factor, and the pathway criteria identify suspected risk, not biopsy-confirmed disease.