Emergency Physician Notification of CT-detected Hepatic Steatosis

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition globally and a leading cause of liver-related morbidity. Although often asymptomatic, MASLD is frequently identified incidentally on emergency department (ED) imaging. Timely patient notification is critical, as early intervention may alter disease trajectory.

To determine the proportion of ED patients with CT evidence of hepatic steatosis who recall being informed of the diagnosis by their ED physician.

We conducted a retrospective cohort study with prospective follow-up at two ED sites within the Maimonides Health system from March to June 2025. Adult patients (18-80 years) with incidental hepatic steatosis noted on CT imaging were identified. Exclusion criteria included hospital admission, non-English language, known liver disease, alcohol use disorder, or psychiatric conditions precluding interview. Structured telephone interviews assessed patient recall of physician notification. The primary outcome was patient-reported awareness of the diagnosis.

Of 171 eligible patients, 150 completed interviews (mean age 47.2 years; 50% female). Only 17 patients (11.3%) recalled being informed of their diagnosis. Notification rates did not differ significantly by sex (13.3% men vs. 9.3% women; P = .440).

Fewer than one in eight ED patients with CT evidence of hepatic steatosis recalled being notified of their diagnosis. This communication gap represents a missed opportunity for early MASLD intervention and underscores the need for systematic approaches to ensure patient awareness and follow-up.