Qianqian Li1, Yunhai Wu2, Qiang Zhu3, Fanping Meng4, Su Lin5, Bang Liu6, Bimin Li7, Shanhong Tang8, Yida Yang9, Yiling Li10, Shanshan Yuan11, Yu Chen12, Xingshun Qi1. 1. Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, China. 2. Department of Critical Care Medicine, The Sixth People's Hospital of Shenyang, Shenyang 110006, China. 3. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China. 4. Department for Biological Therapy, The Fifth Medical Center of PLA General Hospital, Beijing 100039, China. 5. Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. 6. Department of Hepatobiliary Disease, 900 Hospital of the Joint Logistics Team (formerly called Fuzhou General Hospital), Fuzhou 350025, China. 7. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China. 8. Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, China. 9. State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China. 10. Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China. 11. Department of Gastroenterology, Xi'an Central Hospital, Xi'an 710003, China. 12. Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China.
Abstract
BACKGROUND: Our previous study developed Liaoning score as a non-invasive approach for predicting esophageal varices (EVs) in liver cirrhosis. This nationwide multicenter cross-sectional study aimed to externally validate the diagnostic accuracy of Liaoning score and further evaluate its performance for predicting high-risk EVs. METHODS: Cirrhotic patients with acute gastrointestinal bleeding (GIB) without history of endoscopic variceal therapy who underwent endoscopic examinations at their admissions were included. Liaoning score and several non-invasive liver fibrosis scores, including aspartate aminotransferase (AST) to platelet ratio index (APRI), AST to alanine aminotransferase ratio (AAR), fibrosis 4 index (FIB-4), King, and Lok scores, were evaluated. Area under curves (AUCs), cut-off value, sensitivity, and specificity were calculated. RESULTS: Overall, 612 patients were included. The prevalence of EVs and high-risk EVs was 96.2% and 95.6%, respectively. In overall patients, the AUCs of Liaoning score for predicting EVs and high-risk EVs were higher than non-invasive liver fibrosis scores (0.737 versus 0.626-0.721; 0.734 versus 0.611-0.719). The cut-off value of Liaoning score for high-risk EVs was 0.477 with a sensitivity of 81.96% and a specificity of 65.22%. In patients with hematemesis, Liaoning score could significantly predict EVs and high-risk EVs (AUCs =0.708 and 0.702, respectively), but not non-invasive liver fibrosis scores. The cut-off value of Liaoning score for high-risk EVs was 0.437 with a sensitivity of 83.16% and a specificity of 60%. CONCLUSIONS: Liaoning score should be a non-invasive alternative for predicting EVs and high-risk EVs in cirrhotic patients with acute GIB. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: Our previous study developed Liaoning score as a non-invasive approach for predicting esophageal varices (EVs) in liver cirrhosis. This nationwide multicenter cross-sectional study aimed to externally validate the diagnostic accuracy of Liaoning score and further evaluate its performance for predicting high-risk EVs. METHODS: Cirrhotic patients with acute gastrointestinal bleeding (GIB) without history of endoscopic variceal therapy who underwent endoscopic examinations at their admissions were included. Liaoning score and several non-invasive liver fibrosis scores, including aspartate aminotransferase (AST) to platelet ratio index (APRI), AST to alanine aminotransferase ratio (AAR), fibrosis 4 index (FIB-4), King, and Lok scores, were evaluated. Area under curves (AUCs), cut-off value, sensitivity, and specificity were calculated. RESULTS: Overall, 612 patients were included. The prevalence of EVs and high-risk EVs was 96.2% and 95.6%, respectively. In overall patients, the AUCs of Liaoning score for predicting EVs and high-risk EVs were higher than non-invasive liver fibrosis scores (0.737 versus 0.626-0.721; 0.734 versus 0.611-0.719). The cut-off value of Liaoning score for high-risk EVs was 0.477 with a sensitivity of 81.96% and a specificity of 65.22%. In patients with hematemesis, Liaoning score could significantly predict EVs and high-risk EVs (AUCs =0.708 and 0.702, respectively), but not non-invasive liver fibrosis scores. The cut-off value of Liaoning score for high-risk EVs was 0.437 with a sensitivity of 83.16% and a specificity of 60%. CONCLUSIONS: Liaoning score should be a non-invasive alternative for predicting EVs and high-risk EVs in cirrhotic patients with acute GIB. 2019 Annals of Translational Medicine. All rights reserved.
Authors: Raja Chandra Chakinala; Anila Kumar; Jonathan E Barsa; Dhruv Mehta; Khwaja F Haq; Shantanu Solanki; Virendra Tewari; Wilbert S Aronow Journal: Ann Transl Med Date: 2018-12