AI Article Synopsis
- Recent research suggests that combining spleen stiffness (SS) measurements with Baveno VI criteria can effectively reduce the need for screening endoscopy in patients with high-risk varices (HRV).
- A study involving 274 liver disease patients revealed that SS values provide a reliable prediction for HRV, outperforming traditional methods (AUROC values of 0.701, 0.757, and 0.844 for platelet count, liver stiffness, and spleen stiffness, respectively).
- Using both the Baveno VI criteria and SS together allowed 36.1% of patients to avoid endoscopy, indicating that this combined approach is a safe alternative for managing HRV screenings.
Article Abstract
Purpose: Recently, Colecchia et al. reported that by adding a spleen stiffness (SS) criterion sequentially to the Baveno VI criteria, screening endoscopy could be safely avoided. We aimed to compare the Baveno VI criteria, SS values and a sequential combination of the Baveno VI and SS values, measured by supersonic shear imaging (SSI), as approaches for safely avoiding screening endoscopy for high-risk varices (HRV).
Materials And Methods: Between April 2017 and July 2018, we enrolled 274 compensated advanced chronic liver disease patients who had successfully undergone liver stiffness (LS) and SS measurements with SSI and esophagogastroduodenoscopy (EGD). 52 HRV patients were included, and we analyzed risk factors for HRV and compared proportions of patients who were spared EGD when Baveno VI criteria, SS cut-off and the combination of the two approaches were used.
Results: The AUROC values for estimating HRV by platelet count, LS and SS were 0.701, 0.757 and 0.844, respectively, and all three measures were found to be independent predictors of HRV. The SS cut-off value for excluding HRV was ≤ 27.3 kPa. The percentages of patients spared EGD were 18.6 % for Baveno VI, 28.8 % for SS cut-off and 36.1 % for the sequential combination of Baveno VI and SS cut-off. Less than 2 % of HRV patients were missed when using all of the criteria.
Conclusion: The Baveno VI criteria can be applied to LS measurement by SSI. SS measurement by SSI is an excellent predictor of HRV. Screening endoscopy can be safely avoided when Baveno VI criteria and SS cut-off are applied together.
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| http://dx.doi.org/10.1055/a-1168-6271 | DOI Listing |
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