A clinical predictor of varices and portal hypertensive gastropathy in patients with chronic liver disease
Clinical and Molecular Hepatology
;
: 178-184, 2012.
Article
in English
| WPRIM
| ID: wpr-101280
ABSTRACT
BACKGROUND/AIMS:
The aim of this study was to identify the parameters that could noninvasively predict the presence of esophageal/gastric varices and portal hypertensive gastropathy (PHG) in patients with chronic liver disease (CLD), and to determine the accuracy of those parameters.METHODS:
We retrospectively analyzed 232 patients with CLD who underwent both upper endoscopy and liver CT within an interval of 3 months. The multidimensional index (M-Index) for spleen volume was obtained from the multiplication of splenic length, width, and thickness, as measured by computer tomography.RESULTS:
The multivariate analysis revealed that platelet, albumin, and M-Index were independently associated with the presence of varices and PHG. We combined three independent parameters, and developed a varices and portal hypertensive gastropathy (VAP) scoring system (=[platelet count (/mm3)xalbumin (g/dL)]/[M-Index (cm3)]). The area under the receiver operating characteristic curve of the VAP score was 0.850 (95% confidence interval, 0.801-0.899). The VAP cut-off value of 861 had a sensitivity of 85.3%, a positive likelihood ratio of 3.17, and a negative predictive value of 86.4%. For predicting high-risk lesions for bleeding, with a cut-off value of 861 the sensitivity was 92.0%, the positive likelihood ratio was 2.20, and the negative predictive value was 96.4%.CONCLUSIONS:
The VAP score can predict the presence of varices and PHG in patients with CLD and may increase the cost-benefit of screening endoscopy in the clinical practice setting. A prospective validation study is necessary in the future.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Platelet Count
/
Spleen
/
Severity of Illness Index
/
Serum Albumin
/
Esophageal and Gastric Varices
/
Tomography, X-Ray Computed
/
Chronic Disease
/
Predictive Value of Tests
/
Retrospective Studies
/
Risk Factors
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Clinical and Molecular Hepatology
Year:
2012
Type:
Article
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