Authors (including presenting author) :
Ko KL(1), Ku TT(1), Hui KY(1), Ho CY(1), Chung WK (1), Seto WK(1)(2), Yuen MF(1)(2), Mak LY(1)(2)
Affiliation :
(1) Department of Medicine, Queen Mary Hospital (2) Division of Gastroenterology and Hepatology, Department of Medicine, HKU Li Ka Shing Faculty of Medicine
Keyword 1: :
Steatotic / fatty liver disease
Keyword 2: :
SOPD waiting time
Keyword 3: :
day center model
Keyword 4: :
chronic liver disease
Introduction :
Metabolic dysfunction-associated steatiotic liver disease (MASLD), previously known as fatty liver disease, affects about 30% of the population in Hong Kong. More than half of the patients with metabolic syndrome will have liver steatosis with or without fibrosis. With rising awareness and testing such as liver sonography as part of health screening, there has been a ten-fold increase in referral to our SOPD for fatty liver disease. It contributes significantly to the long SOPD new case waiting time and overall caseload for subsequent follow up. We pioneered an integrated model to facilitate management and triage of newly referred cases of fatty liver disease.
Objectives :
1/ To establish a locally applicable protocol based on international guideline to provide quality care for patients with steatotic liver disease 2/ Reduce SOPD waiting time and improve patient journey with expedited assessment and counseling at medical day center 3/ Provide efficient care for patients with steatotic liver disease by triaging them to appropriate level of care
Methodology :
New case referrals to QMH hepatology SOPD are screened and expedited assessment will be arranged at day center for steatotic liver disease. A trained hepatology nurse performs a comprehensive assessment guided by a pre-defined clinical protocol consisting of history taking with standardized questionnaire, anthropometric measurement, baseline blood test (eg. liver function, viral hepatitis serology, fasting bloods), and liver stiffness measurement (LSM). Patients receive counseling on the same session regarding the diagnosis of steatotic liver disease, advised on lifestyle modification and regular monitoring. The patients will be seen by dedicated specialists at the subsequent new case visit and further follow up plan can be decided after reviewing the investigation.
Result & Outcome :
Between December 2024 and November 2025, 340 patients are recruited and managed through the integrated assessment pathway. The mean age is 53, and 161 (47.4%) are male. The mean BMI is 27.6, with 235 (69.1%) patients being obese (BMI >25). Liver function is elevated (ALT > 30) in 209 (61.5%) and significant fibrosis (LSM > 8) is present in 83 (24.4%). Using the criteria of normal ALT and absence of significant fibrosis, one third of the patients can be referred out after a single SOPD visit. The new case waiting time is reduced from over 100 weeks to lowest of 41 weeks after implementation of the clinical model. In conclusion, we showed that a dedicated assessment protocol is feasible and effective in coping with the increasing service demand from steatotic liver disease.
