Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis
Background The Baveno VI criteria (B6C) have been recommended to screen high-risk varices (HRV) in patients with liver cirrhosis to avoid the use of esophagogastroduodenoscopy (EGD). Due to conservative nature of B6C and the general unavailability of transient elastography in the medical institution...
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| Veröffentlicht in: | Hepatology international 2022-08, Vol.16 (4), p.936-943 |
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| creator | Zhao, Lili Wang, Ting Guo, Chunxia Zhou, Li Han, Ping Wang, Chunyan Ma, Ying Wang, Jing Gao, Min Li, Jia |
| description | Background
The Baveno VI criteria (B6C) have been recommended to screen high-risk varices (HRV) in patients with liver cirrhosis to avoid the use of esophagogastroduodenoscopy (EGD). Due to conservative nature of B6C and the general unavailability of transient elastography in the medical institutions, clinical application of B6C is restricted. We aimed to optimize B6C and attempted to replace the liver stiffness (LS) score with other parameters that could help patients avoid EGD.
Methods
A total of 1,188 patients with compensated cirrhosis were analyzed and divided into the training cohort (TC) and validating cohort (VC) by the split-sample method. Variables were selected to develop new criteria in the TC before verification in the VC.
Results
The parameters of age ≥ 50 years, LS, platelet count (PLT), and spleen area (SA) were independently associated with HRV. The risk of HRV was 2.39 times greater in patients over 50 years, hence alternative B6C (AB6C) and modified B6C (MB6C) criteria were built based on age. MB6C was built by adjusting the cut-off value of LS and PLT (patients aged 100 × 10
9
/L and LS 125 × 10
9
/L and LS |
| doi_str_mv | 10.1007/s12072-022-10359-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9349062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2697695451</sourcerecordid><originalsourceid>FETCH-LOGICAL-c451t-26da784d8a10021b8da1d4b7586bd3f5631b3e3c45b5ed371ef58714f4277bc33</originalsourceid><addsrcrecordid>eNp9kUtv3CAURlHUKu8_0BVSN9045WHA3lRqoyaNlKibNluE4dom9cAU7Klml58ekolSNYsuEAjOPbqXD6F3lJxRQtTHTBlRrCKMVZRw0VbbPXRIWy4rImr65uXM-QE6yvmOECEklfvogAvFlCDkEN3fROd7Dw6bUNY0Qwpm9hvAX8wGQsS3V9gmX669wZ3JBYwBmwFwHxNOy-TDgOMy49EPY5V8_oU3JnkLGfuA10UFYc74j59HbONqDSGbuUisT2mM2ecT9LY3U4bT5_0Y_bz4-uP8W3X9_fLq_PN1ZWtB54pJZ1RTu8aU0RntGmeoqzslGtk53gvJaceBF7gT4Lii0ItG0bqvmVKd5fwYfdp510u3AmdLW8lMep38yqStjsbrf1-CH_UQN7rldUskK4IPz4IUfy-QZ73y2cI0mQBxyZpJ1TLeEFYX9P0r9C4u5V-nR6pVshVlpkKxHWVTzDlB_9IMJfoxYL0LWJeA9VPAeluK-K4oFzgMkP6q_1P1AOrlqfU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2697695451</pqid></control><display><type>article</type><title>Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis</title><source>SpringerNature Journals</source><creator>Zhao, Lili ; Wang, Ting ; Guo, Chunxia ; Zhou, Li ; Han, Ping ; Wang, Chunyan ; Ma, Ying ; Wang, Jing ; Gao, Min ; Li, Jia</creator><creatorcontrib>Zhao, Lili ; Wang, Ting ; Guo, Chunxia ; Zhou, Li ; Han, Ping ; Wang, Chunyan ; Ma, Ying ; Wang, Jing ; Gao, Min ; Li, Jia</creatorcontrib><description><![CDATA[Background
The Baveno VI criteria (B6C) have been recommended to screen high-risk varices (HRV) in patients with liver cirrhosis to avoid the use of esophagogastroduodenoscopy (EGD). Due to conservative nature of B6C and the general unavailability of transient elastography in the medical institutions, clinical application of B6C is restricted. We aimed to optimize B6C and attempted to replace the liver stiffness (LS) score with other parameters that could help patients avoid EGD.
Methods
A total of 1,188 patients with compensated cirrhosis were analyzed and divided into the training cohort (TC) and validating cohort (VC) by the split-sample method. Variables were selected to develop new criteria in the TC before verification in the VC.
Results
The parameters of age ≥ 50 years, LS, platelet count (PLT), and spleen area (SA) were independently associated with HRV. The risk of HRV was 2.39 times greater in patients over 50 years, hence alternative B6C (AB6C) and modified B6C (MB6C) criteria were built based on age. MB6C was built by adjusting the cut-off value of LS and PLT (patients aged < 50 years with PLT > 100 × 10
9
/L and LS < 30 kPa; patients aged ≥ 50 years with a combined PLT > 125 × 10
9
/L and LS < 20 kPa). MB6C helped avoid EGD in 310 (51.2%) patients, whereas 7 (2.3%) cases of HRV were missed. The predicting performance HRV showed no statistical difference between PLT, SA, or LS. SA was selected to replace LS and in the built AB6C (patients aged < 50 years with PLT > 100 × 10
9
/L and SA < 55 cm
2
; patients aged ≥ 50 years with a combined PLT > 125 × 10
9
/L and SA < 44 cm
2
). Using AB6C avoided 297 (49.1%) EGDs with a total of 8 (2.7%) cases of HRV that were missed.
Conclusions
Our novel MB6C and AB6C were stratified by age and provided excellent performance for ruling out HRV, which performed better than B6C and EB6C (expanded B6C) in helping to avoid EGD screening.
Clinical trial registration number
ChiCTR-DDD-17013845.]]></description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-022-10359-y</identifier><identifier>PMID: 35727500</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Age ; ChiCTR-DDD ; ChiCTR-DDD-17013845 ; Cirrhosis ; Colorectal Surgery ; Criteria ; Health care facilities ; Hepatology ; Liver ; Liver cirrhosis ; Medicine ; Medicine & Public Health ; Original ; Original Article ; Parameters ; Patients ; Performance prediction ; Risk ; Spleen ; Stiffness ; Surgery</subject><ispartof>Hepatology international, 2022-08, Vol.16 (4), p.936-943</ispartof><rights>The Author(s) 2022</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-26da784d8a10021b8da1d4b7586bd3f5631b3e3c45b5ed371ef58714f4277bc33</citedby><cites>FETCH-LOGICAL-c451t-26da784d8a10021b8da1d4b7586bd3f5631b3e3c45b5ed371ef58714f4277bc33</cites><orcidid>0000-0003-0100-417X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12072-022-10359-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12072-022-10359-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27929,27930,41493,42562,51324</link.rule.ids></links><search><creatorcontrib>Zhao, Lili</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Guo, Chunxia</creatorcontrib><creatorcontrib>Zhou, Li</creatorcontrib><creatorcontrib>Han, Ping</creatorcontrib><creatorcontrib>Wang, Chunyan</creatorcontrib><creatorcontrib>Ma, Ying</creatorcontrib><creatorcontrib>Wang, Jing</creatorcontrib><creatorcontrib>Gao, Min</creatorcontrib><creatorcontrib>Li, Jia</creatorcontrib><title>Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><description><![CDATA[Background
The Baveno VI criteria (B6C) have been recommended to screen high-risk varices (HRV) in patients with liver cirrhosis to avoid the use of esophagogastroduodenoscopy (EGD). Due to conservative nature of B6C and the general unavailability of transient elastography in the medical institutions, clinical application of B6C is restricted. We aimed to optimize B6C and attempted to replace the liver stiffness (LS) score with other parameters that could help patients avoid EGD.
Methods
A total of 1,188 patients with compensated cirrhosis were analyzed and divided into the training cohort (TC) and validating cohort (VC) by the split-sample method. Variables were selected to develop new criteria in the TC before verification in the VC.
Results
The parameters of age ≥ 50 years, LS, platelet count (PLT), and spleen area (SA) were independently associated with HRV. The risk of HRV was 2.39 times greater in patients over 50 years, hence alternative B6C (AB6C) and modified B6C (MB6C) criteria were built based on age. MB6C was built by adjusting the cut-off value of LS and PLT (patients aged < 50 years with PLT > 100 × 10
9
/L and LS < 30 kPa; patients aged ≥ 50 years with a combined PLT > 125 × 10
9
/L and LS < 20 kPa). MB6C helped avoid EGD in 310 (51.2%) patients, whereas 7 (2.3%) cases of HRV were missed. The predicting performance HRV showed no statistical difference between PLT, SA, or LS. SA was selected to replace LS and in the built AB6C (patients aged < 50 years with PLT > 100 × 10
9
/L and SA < 55 cm
2
; patients aged ≥ 50 years with a combined PLT > 125 × 10
9
/L and SA < 44 cm
2
). Using AB6C avoided 297 (49.1%) EGDs with a total of 8 (2.7%) cases of HRV that were missed.
Conclusions
Our novel MB6C and AB6C were stratified by age and provided excellent performance for ruling out HRV, which performed better than B6C and EB6C (expanded B6C) in helping to avoid EGD screening.
Clinical trial registration number
ChiCTR-DDD-17013845.]]></description><subject>Age</subject><subject>ChiCTR-DDD</subject><subject>ChiCTR-DDD-17013845</subject><subject>Cirrhosis</subject><subject>Colorectal Surgery</subject><subject>Criteria</subject><subject>Health care facilities</subject><subject>Hepatology</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original</subject><subject>Original Article</subject><subject>Parameters</subject><subject>Patients</subject><subject>Performance prediction</subject><subject>Risk</subject><subject>Spleen</subject><subject>Stiffness</subject><subject>Surgery</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><recordid>eNp9kUtv3CAURlHUKu8_0BVSN9045WHA3lRqoyaNlKibNluE4dom9cAU7Klml58ekolSNYsuEAjOPbqXD6F3lJxRQtTHTBlRrCKMVZRw0VbbPXRIWy4rImr65uXM-QE6yvmOECEklfvogAvFlCDkEN3fROd7Dw6bUNY0Qwpm9hvAX8wGQsS3V9gmX669wZ3JBYwBmwFwHxNOy-TDgOMy49EPY5V8_oU3JnkLGfuA10UFYc74j59HbONqDSGbuUisT2mM2ecT9LY3U4bT5_0Y_bz4-uP8W3X9_fLq_PN1ZWtB54pJZ1RTu8aU0RntGmeoqzslGtk53gvJaceBF7gT4Lii0ItG0bqvmVKd5fwYfdp510u3AmdLW8lMep38yqStjsbrf1-CH_UQN7rldUskK4IPz4IUfy-QZ73y2cI0mQBxyZpJ1TLeEFYX9P0r9C4u5V-nR6pVshVlpkKxHWVTzDlB_9IMJfoxYL0LWJeA9VPAeluK-K4oFzgMkP6q_1P1AOrlqfU</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Zhao, Lili</creator><creator>Wang, Ting</creator><creator>Guo, Chunxia</creator><creator>Zhou, Li</creator><creator>Han, Ping</creator><creator>Wang, Chunyan</creator><creator>Ma, Ying</creator><creator>Wang, Jing</creator><creator>Gao, Min</creator><creator>Li, Jia</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0100-417X</orcidid></search><sort><creationdate>20220801</creationdate><title>Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis</title><author>Zhao, Lili ; Wang, Ting ; Guo, Chunxia ; Zhou, Li ; Han, Ping ; Wang, Chunyan ; Ma, Ying ; Wang, Jing ; Gao, Min ; Li, Jia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-26da784d8a10021b8da1d4b7586bd3f5631b3e3c45b5ed371ef58714f4277bc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>ChiCTR-DDD</topic><topic>ChiCTR-DDD-17013845</topic><topic>Cirrhosis</topic><topic>Colorectal Surgery</topic><topic>Criteria</topic><topic>Health care facilities</topic><topic>Hepatology</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original</topic><topic>Original Article</topic><topic>Parameters</topic><topic>Patients</topic><topic>Performance prediction</topic><topic>Risk</topic><topic>Spleen</topic><topic>Stiffness</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Lili</creatorcontrib><creatorcontrib>Wang, Ting</creatorcontrib><creatorcontrib>Guo, Chunxia</creatorcontrib><creatorcontrib>Zhou, Li</creatorcontrib><creatorcontrib>Han, Ping</creatorcontrib><creatorcontrib>Wang, Chunyan</creatorcontrib><creatorcontrib>Ma, Ying</creatorcontrib><creatorcontrib>Wang, Jing</creatorcontrib><creatorcontrib>Gao, Min</creatorcontrib><creatorcontrib>Li, Jia</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhao, Lili</au><au>Wang, Ting</au><au>Guo, Chunxia</au><au>Zhou, Li</au><au>Han, Ping</au><au>Wang, Chunyan</au><au>Ma, Ying</au><au>Wang, Jing</au><au>Gao, Min</au><au>Li, Jia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><date>2022-08-01</date><risdate>2022</risdate><volume>16</volume><issue>4</issue><spage>936</spage><epage>943</epage><pages>936-943</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract><![CDATA[Background
The Baveno VI criteria (B6C) have been recommended to screen high-risk varices (HRV) in patients with liver cirrhosis to avoid the use of esophagogastroduodenoscopy (EGD). Due to conservative nature of B6C and the general unavailability of transient elastography in the medical institutions, clinical application of B6C is restricted. We aimed to optimize B6C and attempted to replace the liver stiffness (LS) score with other parameters that could help patients avoid EGD.
Methods
A total of 1,188 patients with compensated cirrhosis were analyzed and divided into the training cohort (TC) and validating cohort (VC) by the split-sample method. Variables were selected to develop new criteria in the TC before verification in the VC.
Results
The parameters of age ≥ 50 years, LS, platelet count (PLT), and spleen area (SA) were independently associated with HRV. The risk of HRV was 2.39 times greater in patients over 50 years, hence alternative B6C (AB6C) and modified B6C (MB6C) criteria were built based on age. MB6C was built by adjusting the cut-off value of LS and PLT (patients aged < 50 years with PLT > 100 × 10
9
/L and LS < 30 kPa; patients aged ≥ 50 years with a combined PLT > 125 × 10
9
/L and LS < 20 kPa). MB6C helped avoid EGD in 310 (51.2%) patients, whereas 7 (2.3%) cases of HRV were missed. The predicting performance HRV showed no statistical difference between PLT, SA, or LS. SA was selected to replace LS and in the built AB6C (patients aged < 50 years with PLT > 100 × 10
9
/L and SA < 55 cm
2
; patients aged ≥ 50 years with a combined PLT > 125 × 10
9
/L and SA < 44 cm
2
). Using AB6C avoided 297 (49.1%) EGDs with a total of 8 (2.7%) cases of HRV that were missed.
Conclusions
Our novel MB6C and AB6C were stratified by age and provided excellent performance for ruling out HRV, which performed better than B6C and EB6C (expanded B6C) in helping to avoid EGD screening.
Clinical trial registration number
ChiCTR-DDD-17013845.]]></abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>35727500</pmid><doi>10.1007/s12072-022-10359-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0100-417X</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1936-0533 |
| ispartof | Hepatology international, 2022-08, Vol.16 (4), p.936-943 |
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| language | eng |
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| source | SpringerNature Journals |
| subjects | Age ChiCTR-DDD ChiCTR-DDD-17013845 Cirrhosis Colorectal Surgery Criteria Health care facilities Hepatology Liver Liver cirrhosis Medicine Medicine & Public Health Original Original Article Parameters Patients Performance prediction Risk Spleen Stiffness Surgery |
| title | Modified and alternative Baveno VI criteria based on age for ruling out high-risk varices in patients with compensated cirrhosis |
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