Pik-Eu Chang1, Chee-Kiat Tan1, Chang-Chuen Cheah1, Weiquan Li2, Wan Cheng Chow1, Yu-Jun Wong3. 1. Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore. 2. Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore. 3. Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore. Eugene.wong.y.j@singhealth.com.sg.
Abstract
BACKGROUND: The expanded Baveno-VI criteria may further reduce the need for screening gastroscopy compared to Baveno-VI criteria. AIM: We sought to validate the performance of these criteria in a cohort of compensated advanced chronic liver disease (cACLD) patients with predominantly hepatitis B infection. METHODS: Consecutive cACLD patients from 2006 to 2012 with paired liver stiffness measurements and screening gastroscopy within 1 year were included. The expanded Baveno-VI criteria were applied to evaluate the sensitivity (SS), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) for the presence of high-risk varices (HRV). RESULTS: Among 165 cACLD patients included, 17 (10.3%) had HRV. The commonest etiology of cACLD was chronic hepatitis B (36.4%) followed by NAFLD (20.0%). Application of expanded Baveno-VI criteria avoided more screening gastroscopy (43.6%) as compared to the original Baveno-VI criteria (18.8%) without missing more HRV (1 with both criteria). The overall SS, SP, PPV and NPV of the expanded Baveno-VI criteria in predicting HRV were 94.1%, 48.0%, 17.2% and 98.6%, respectively. CONCLUSION: Application of the expanded Baveno-VI criteria can safely avoid screening gastroscopy in 43.6% of cACLD patients with an excellent ability to exclude HRV.
BACKGROUND: The expanded Baveno-VI criteria may further reduce the need for screening gastroscopy compared to Baveno-VI criteria. AIM: We sought to validate the performance of these criteria in a cohort of compensated advanced chronic liver disease (cACLD) patients with predominantly hepatitis B infection. METHODS: Consecutive cACLD patients from 2006 to 2012 with paired liver stiffness measurements and screening gastroscopy within 1 year were included. The expanded Baveno-VI criteria were applied to evaluate the sensitivity (SS), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) for the presence of high-risk varices (HRV). RESULTS: Among 165 cACLD patients included, 17 (10.3%) had HRV. The commonest etiology of cACLD was chronic hepatitis B (36.4%) followed by NAFLD (20.0%). Application of expanded Baveno-VI criteria avoided more screening gastroscopy (43.6%) as compared to the original Baveno-VI criteria (18.8%) without missing more HRV (1 with both criteria). The overall SS, SP, PPV and NPV of the expanded Baveno-VI criteria in predicting HRV were 94.1%, 48.0%, 17.2% and 98.6%, respectively. CONCLUSION: Application of the expanded Baveno-VI criteria can safely avoid screening gastroscopy in 43.6% of cACLD patients with an excellent ability to exclude HRV.
Entities:
Keywords:
Esophageal and gastric varices; Gastroscopy; Hypertension, Portal; Liver cirrhosis
Authors: Han Ah Lee; Seung Up Kim; Yeon Seok Seo; Young-Sun Lee; Seong Hee Kang; Young Kul Jung; Moon Young Kim; Ji Hoon Kim; Sang Gyune Kim; Ki Tae Suk; Soung Won Jung; Jae Young Jang; Hyonggin An; Hyung Joon Yim; Soon Ho Um Journal: Liver Int Date: 2019-02-06 Impact factor: 5.828
Authors: Nik S Ding; Tin Nguyen; David M Iser; Thai Hong; Emma Flanagan; Avelyn Wong; Lauren Luiz; Jonathan Y C Tan; James Fulforth; Jacinta Holmes; Marno Ryan; Sally J Bell; Paul V Desmond; Stuart K Roberts; John Lubel; William Kemp; Alexander J Thompson Journal: Liver Int Date: 2015-09-06 Impact factor: 5.828