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236810

Value of Non-Invasive Scores and Modalities in Predicting the Presence of Esophageal Varices in Patients with Liver Cirrhosis

Article

Last updated: 24 Dec 2024

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Abstract

  Background: Esophageal varices (EVs) represent the main complication of portal hypertension and carry a significant risk of morbidity and mortality. Esophagogastroduodenoscopy (EGD) is the gold standard test for screening of esophageal varices in patients with cirrhosis, but many studies explored noninvasive modalities in order to overcome its cost and invasiveness. Objective: The aim of the current work was to assess the potential role of five non-invasive scoring systems/modalities (AST to platelet ratio index {APRI} score, ALT/AST ratio {AAR}, fibrosis – 4 {FIB-4} index, King's score, and platelet count/ spleen diameter {PC/SD ratio}) in detection of esophageal varices in patients with liver cirrhosis. Patients and Methods: This prospective cohort study included a total of 120 cirrhotic patients, attending at Hepatology Outpatient Clinic, Endoscopy Unit and Radiodiagnosis Department, El-Demerdash Hospital, Ain Shams University. Patients were classified according to presence of esophageal varices (EVs) detected by esophagogastroduodenoscopy (EGD) into two groups; Group 1 consisted of 9 patients with no EVs, and Group 2 consisted of 111 patients with EVs. group II were further subdivided according to the grade of esophageal varices (EVs) into three subgroups. The following noninvasive scores and indices were calculated for all patients: APRIscore, AAR, FIB-4 index, King's score, and PC/SD ratio.Results: Among the five scores studied, AAR at a cut off value >0.88 showed the greatest sensitivity (86.49%) and accuracy (92.8 %), followed by PC/SD ratio at a cut off value <668.97 with an 86.49% sensitivity and 90.1% accuracy and FIB-4 index at a cut off value >5.1 with an 83.78% sensitivity and 90.1% accuracy. While the least sensitive scores were APRI and King's score with a 70.27% and 67.57% sensitivity respectively. Conclusion: It could be concluded that AAR and PC/SD ratio are the most sensitive scores that can predict the presence of esophageal varices (EVs) in cirrhotic patients with acceptable accuracy. Being cheap and applicable they could be used as an initial screening tests to detect esophageal varices in patients with liver cirrhosis.  

DOI

10.21608/ejhm.2022.236810

Keywords

Liver cirrhosis, Esophageal varices, Non-invasive scores, Non-Invasive modalities

Authors

First Name

Heba A.

Last Name

Faheem

MiddleName

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Affiliation

Internal medicine department , Gastroenterology and hepatology unit, Faculty of Medicine, ain shams University, Cairo, Egypt

Email

dr.hebafaheem@med.asu.edu.eg

City

-

Orcid

0000-0002-2163-3339

First Name

Marwa Ahmed

Last Name

Mohamed

MiddleName

-

Affiliation

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Email

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City

-

Orcid

-

First Name

Engy Ezzat

Last Name

Eid

MiddleName

-

Affiliation

-

Email

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City

-

Orcid

-

First Name

Nouran Mohamed

Last Name

Said

MiddleName

-

Affiliation

-

Email

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City

-

Orcid

-

Volume

88

Article Issue

1

Related Issue

33970

Issue Date

2022-07-01

Receive Date

2022-05-13

Publish Date

2022-07-01

Page Start

2,464

Page End

2,471

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_236810.html

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https://ejhm.journals.ekb.eg/service?article_code=236810

Order

29

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Value of Non-Invasive Scores and Modalities in Predicting the Presence of Esophageal Varices in Patients with Liver Cirrhosis

Details

Type

Article

Created At

22 Jan 2023