NAFLD Fibrosis Score Calculator
A validated non-invasive tool for staging fibrosis in NAFLD
Last updated on: July 10, 2025
NAFLD Fibrosis Score (NFS)
What is the NAFLD Fibrosis Score?
The NAFLD Fibrosis Score (NFS) is a widely used and validated clinical scoring system designed to identify patients with non-alcoholic fatty liver disease (NAFLD) who are at high risk for advanced liver fibrosis (stages F3-F4).
It combines six readily available clinical and laboratory variables: age, BMI, presence of diabetes, AST, ALT, platelet count, and albumin level.
Why is the NFS Score Important?
- It has a high negative predictive value, making it excellent for ruling out advanced fibrosis and avoiding unnecessary liver biopsies in low-risk patients.
- Helps stratify patients, allowing clinicians to focus resources and specialist referrals on those at the highest risk.
- Recommended by major international guidelines (AASLD, EASL) as a first-line non-invasive test for NAFLD.
Interpreting the Score (Validated Cutoffs)
Score < -1.455:
Low risk for advanced fibrosis (High NPV).
Score -1.455 to 0.675:
Indeterminate risk. Further testing is recommended.
Score > 0.675:
High risk for advanced fibrosis. Specialist referral advised.
Clinical Pathway & Management
The NFS score is a crucial part of the diagnostic pathway for NAFLD, guiding the next steps in patient management.
- Low Risk (Score < -1.455): Advanced fibrosis is unlikely. Management typically focuses on lifestyle modifications.
- Intermediate Risk (Score -1.455 to 0.675): The risk is indeterminate. Further non-invasive tests, like FibroScan® or other fibrosis markers, are recommended.
- High Risk (Score > 0.675): There is a high probability of advanced fibrosis. Referral to a hepatologist for further evaluation is essential.
This page has been medically reviewed by Dr. Khoulah Attia – PharmD, Immunology Specialist.