Ravaioli, Federico; Berger, Arthur; Farcau, Oana; Colecchia, Antonio; Stefanescu, Horia; Candillier, Camille; Nahon, Pierre; Bureau, Christophe; Ganne-Carriè, Nathalie; Berzigotti, Annalisa; de Ledinghen, Victor; Petta, Salvatore; Calès, Paul (2023). Individual and population screening of varices needing treatment by a simple, safe and accurate test. Clinics and research in hepatology and gastroenterology, 47(5), p. 102123. Elsevier Masson 10.1016/j.clinre.2023.102123
|
Text
1-s2.0-S2210740123000487-main.pdf - Accepted Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (1MB) | Preview |
BACKGROUND
Several tests have been developed to screen VNT in different screening settings. We aimed to develop simple estimators to quantify VNT risk and spare endoscopy while missing <5% of VNT, adapted to different screenings in the main etiologies.
METHODS
2,368 patients with chronic liver disease were included. The main VNT predictors were platelets, prothrombin index (PI) and LSM. Their interactions led to score construction, LIP: (LSM*45)/(PI*platelets), and BLIP: BMI-adjusted LIP in NAFLD. Scores were categorized either for population (VNT sensitivity ≥95%) or individual (negative predictive value ≥95%) VNT screening.
RESULTS
1) Scores diagnosing VNT. AUROCs were, PLER: 0.767 Anticipate: 0.773 (p=0.059 vs previous), LIP: 0.779 (p=0.136), PLEASE: 0.789 (p=0.196). 2) Population screening performance was in increasing order (with missed VNT rate), Baveno6 criteria: 23.9% (2.5%), Anticipate 24.5%, p=0.367 vs previous (3.3%), PLER 27.3%, p<0.001 (3.6%), LIP 33.4%, p<0.001 (4.2%), PLEASE 35.2%, p=0.006 (3.6%). In NAFLD, LIP 38.6%, BLIP 40.8%, p=0.038. 3) Individual screening performance was, expanded Baveno6 criteria: 42.7%, LIP 54.1%, p<0.001. In NAFLD, performance was, NAFLD-cirrhosis criteria: 66.7%, BLIP 74.6%, p<0.001.
CONCLUSION
LIP combined simplicity, performance and safety in each etiology. In NAFLD, BMI-adjusted LIP outperformed other tests.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology |
UniBE Contributor: |
Berzigotti, Annalisa |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2210-741X |
Publisher: |
Elsevier Masson |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
17 Apr 2023 12:58 |
Last Modified: |
15 Apr 2024 00:25 |
Publisher DOI: |
10.1016/j.clinre.2023.102123 |
PubMed ID: |
37061034 |
Uncontrolled Keywords: |
Portal hypertension liver elastometry oesophageal varices platelets prothrombin time |
BORIS DOI: |
10.48350/181760 |
URI: |
https://boris.unibe.ch/id/eprint/181760 |
Actions (login required)
 |
Edit item |