Xingshun Qi1, Yiling Li2, Ran Wang3, Lianjie Lin4, Jing Li5, Lijun Wang6, Shuang Zheng7, Yonghong Sun8, Lixin Zhao9, Xiaolin Fu10, Mengchun Wang4, Xinping Qiu11, Han Deng3, Cen Hong3, Qianqian Li3, Hongyu Li3, Xiaozhong Guo12. 1. Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning, China. xingshunqi@126.com. 2. Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, Liaoning, China. 3. Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning, China. 4. Department of Gastroenterology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China. 5. Department of Gastroenterology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China. 6. Department of Gastroenterology, Panjin Central Hospital, Panjin, Liaoning, China. 7. The Sixth People's Hospital of Shenyang, Shenyang, Liaoning, China. 8. Department of Gastroenterology, Dalian Friendship Hospital of Dalian Medical University, Dalian, Liaoning, China. 9. Department of Gastroenterology, General Hospital of Liaohe Oilfield Company, Panjin, Liaoning, China. 10. Department of Gastroenterology, Ansteel Group Hospital, Anshan, Liaoning, China. 11. Department of Gastroenterology, General Hospital of Fuxin Mining Industry Group of Liaoning Health Industry Group, Fuxin, Liaoning, China. 12. Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning, China. guo_xiao_zhong@126.com.
Abstract
BACKGROUND AND AIMS: Endoscopy is necessary for assessment of esophageal varices (EVs) in cirrhotic patients, but its use is limited because of the poor compliance of patients and shortage of public health resources at primary hospitals or rural areas, especially in less well developed countries. A multicenter cross-sectional study aimed to establish a novel non-invasive score for prediction of EVs in cirrhotic patients who had never undergone endoscopy. METHODS: Patients with liver cirrhosis regardless of acute upper gastrointestinal bleeding (AUGIB) who underwent the first-time upper gastrointestinal endoscopy at 11 hospitals in Liaoning Province, China were considered. Independent predictors for EVs were identified by multivariate logistic regression analysis and then combined into an equation. The diagnostic performance with area under curve (AUC) was further evaluated by receiver operating characteristic curve analysis. RESULTS: Overall, 363 patients were included, of whom 260 had EVs and 180 presented with AUGIB. In all patients, AUGIB, ascites, and platelets were the independent predictors for EVs. The equation (i.e., Liaoning score) was 0.466 + 1.088 × AUGIB (1 = yes; 0 = no) + 1.147 × ascites (1 = yes; 0 = no) - 0.012 × platelets, which had an AUC of 0.807 (p < 0.0001). In patients with AUGIB, ascites and platelets were the independent predictors for EVs. The equation was as follows: 1.205 + 1.557 × ascites (1 = yes; 0 = no) - 0.008 × platelets, which had an AUC of 0.782 (p < 0.0001). In patients without AUGIB, platelets was the only independent predictor for EVs, which had an AUC of 0.773 (p < 0.0001). CONCLUSION: The Liaoning score is based on easy-to-access regular clinical and laboratory data and has a good diagnostic performance for non-invasive prediction of EVs in cirrhotic patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02593799.
BACKGROUND AND AIMS: Endoscopy is necessary for assessment of esophageal varices (EVs) in cirrhoticpatients, but its use is limited because of the poor compliance of patients and shortage of public health resources at primary hospitals or rural areas, especially in less well developed countries. A multicenter cross-sectional study aimed to establish a novel non-invasive score for prediction of EVs in cirrhoticpatients who had never undergone endoscopy. METHODS:Patients with liver cirrhosis regardless of acute upper gastrointestinal bleeding (AUGIB) who underwent the first-time upper gastrointestinal endoscopy at 11 hospitals in Liaoning Province, China were considered. Independent predictors for EVs were identified by multivariate logistic regression analysis and then combined into an equation. The diagnostic performance with area under curve (AUC) was further evaluated by receiver operating characteristic curve analysis. RESULTS: Overall, 363 patients were included, of whom 260 had EVs and 180 presented with AUGIB. In all patients, AUGIB, ascites, and platelets were the independent predictors for EVs. The equation (i.e., Liaoning score) was 0.466 + 1.088 × AUGIB (1 = yes; 0 = no) + 1.147 × ascites (1 = yes; 0 = no) - 0.012 × platelets, which had an AUC of 0.807 (p < 0.0001). In patients with AUGIB, ascites and platelets were the independent predictors for EVs. The equation was as follows: 1.205 + 1.557 × ascites (1 = yes; 0 = no) - 0.008 × platelets, which had an AUC of 0.782 (p < 0.0001). In patients without AUGIB, platelets was the only independent predictor for EVs, which had an AUC of 0.773 (p < 0.0001). CONCLUSION: The Liaoning score is based on easy-to-access regular clinical and laboratory data and has a good diagnostic performance for non-invasive prediction of EVs in cirrhoticpatients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02593799.
Authors: Ibrahim F Amer; Eslam M El Shennawy; Hassan El Batea; Mohammed Hussien Ahmed; Shimaa El Sharawy; Aya M Mahros Journal: JGH Open Date: 2021-01-18