90.For practical application, we also developed a simplified model using a single predictor variable Z. When Z1=G1+G2+G6+G8, the AUG was 0.89 and the positive predictive value (PPV) of Z1 > 2 for decompensated cirrhosis was

94%. When C1 and C2 were excluded from the model, the AUG for G6 and G8 alone was 0.75. A third model where Z2=G4+G6+G8+G10 had an AUG of 0.83 and a PPV of 87% for Z2 > 2. Conclusion: Algorithms based on ICD-9 codes related to bleeding esophageal varices and ascites were associated with a high likelihood of identifying CHB and CHC patients with decompensated cirrhosis. This model could constitute a useful tool for epidemiological research and could also be used as a quality improvement measure to electronically prompt timely specialty Proteasome inhibitor referrals and monitor evidence based care of this patient population. Disclosures: Stuart C. Gordon – Advisory Committees or Review Panels: Tibotec; Consulting: Merck, CVS Caremark, Gilead Sciences, BMS; Grant/Research Support: Roche/Genentech, Merck, Vertex Pharmaceuticals, Gilead Sciences, BMS, Abbott, Intercept Pharmaceuticals, Exalenz Sciences, Inc. The following people have nothing to disclose: Wadih Chacra, David Rabin, James J. Yang “
“Estrogens inhibit stellate

cell activation and fibrogenesis. Thus, gender and reproductive states may influence the degree of fibrosis in patients with nonalcoholic steatohepatitis (NASH). To investigate the association between gender, menopause, and the severity of liver fibrosis in patients with NASH, we analyzed 541 Sirolimus adult patients enrolled from our Duke Liver Clinics (n = 338) and the Duke Metabolic and Weight Loss Surgery Program (n = 203) who had a histologic diagnosis of NASH. Multiple ordinal logistic regression models were used to assess the association between gender, menopause, and severity of liver fibrosis. Overall, men, premenopausal, and postmenopausal women composed 35.1%, 28.4%, and 36.5% of the population, respectively. The mean age was 48 years and 22% had advanced fibrosis. After adjusting for covariates (enrolling site, grades of portal inflammation, and hepatocyte ballooning) and potential confounders (race, body mass index, diabetes/prediabetes, hypertension),

adjusted cumulative odd ratio (ACOR) and 95% confidence interval (CI) for greater fibrosis BCKDHB severity was 1.4 (0.9, 2.1) (P = 0.17) for postmenopausal women and 1.6 (1.0, 2.5) (P = 0.03) for men, having premenopausal women as a reference. There was borderline interaction between gender and age group divided by age 50, the average age at menopause in the U.S. (P = 0.08): ACOR and 95% CI of having greater fibrosis severity in men compared to women was 1.8 (1.1, 2.9) for patients with age <50 years (P = 0.02) and 1.2 (0.7, 2.1) for patients with age ≥50 years (P = 0.59). Conclusion: Men are at a higher risk of having more severe fibrosis compared to women before menopause, while postmenopausal women have a similar severity of liver fibrosis compared to men.