New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease
Introduction and objectives: The predictors for gastroesophageal varices (GOV) and hemorrhage development have not been well studied in different liver diseases or different population. This study aimed to evaluate whether a new algorithm focusing on chronic hepatitis B (CHB) patients is also applic...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Annals of Hepatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268120300053 |
| _version_ | 1818741450082353152 |
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| author | Jia-li Ma Ling-ling He Yu Jiang Jun-ru Yang Ping Li Yao Zang Hong-shan Wei |
| author_facet | Jia-li Ma Ling-ling He Yu Jiang Jun-ru Yang Ping Li Yao Zang Hong-shan Wei |
| author_sort | Jia-li Ma |
| collection | DOAJ |
| description | Introduction and objectives: The predictors for gastroesophageal varices (GOV) and hemorrhage development have not been well studied in different liver diseases or different population. This study aimed to evaluate whether a new algorithm focusing on chronic hepatitis B (CHB) patients is also applicable to other chronic liver diseases (CLDs) in Chinese population. Patients or materials and methods: We retrospectively analyzed 659 CHB patients and 386 patients with other CLDs. A total of 439 CHB patients were included in training set, the other 220 CHB patients and other patients with CLDs were included in validation set. A new algorithm for diagnosing GOV was established and its sensitivity and specificity for predicting the varices was verified. Results: Multivariable logistic regression revealed that the rough surface of the liver (p < 0.001), splenic thickness (p < 0.001), and liver stiffness (p = 0.006) were independent predictors of GOV. The new algorithm was considered to be a reliable diagnostic model to evaluate the presence of varices. The AUROC was 0.94 (p < 0.001) in CHB validation set and 0.90 (<0.001) in non-CHB validation set. When the cut-off value was chosen as −1.048, the sensitivity and specificity in diagnosing GOV in CHB population were 89.1% and 82.5%, respectively. Importantly, the new algorithm accurately predicted the variceal hemorrhage not only in CHB patients, but also in patients with other CLDs. Conclusion: The new algorithm is regarded as a reliable model to prognosticate varices and variceal hemorrhage, and stratified not only the high-risk CHB patients, but also in patients with other CLDs for developing GOV and variceal bleeding. |
| first_indexed | 2024-12-18T01:56:49Z |
| format | Article |
| id | doaj.art-5dc4bcc5d6944166bafe8330d1fb66c8 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-18T01:56:49Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-5dc4bcc5d6944166bafe8330d1fb66c82022-12-21T21:24:54ZengElsevierAnnals of Hepatology1665-26812020-05-01193287294New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver diseaseJia-li Ma0Ling-ling He1Yu Jiang2Jun-ru Yang3Ping Li4Yao Zang5Hong-shan Wei6Capital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, ChinaCapital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, ChinaCapital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, ChinaCapital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, ChinaCapital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, ChinaCapital Medical University Affiliated Beijing Ditan Hospital, Department of Medical Ultrasound, Beijing, ChinaDepartment of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China; Corresponding author at: Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China.Introduction and objectives: The predictors for gastroesophageal varices (GOV) and hemorrhage development have not been well studied in different liver diseases or different population. This study aimed to evaluate whether a new algorithm focusing on chronic hepatitis B (CHB) patients is also applicable to other chronic liver diseases (CLDs) in Chinese population. Patients or materials and methods: We retrospectively analyzed 659 CHB patients and 386 patients with other CLDs. A total of 439 CHB patients were included in training set, the other 220 CHB patients and other patients with CLDs were included in validation set. A new algorithm for diagnosing GOV was established and its sensitivity and specificity for predicting the varices was verified. Results: Multivariable logistic regression revealed that the rough surface of the liver (p < 0.001), splenic thickness (p < 0.001), and liver stiffness (p = 0.006) were independent predictors of GOV. The new algorithm was considered to be a reliable diagnostic model to evaluate the presence of varices. The AUROC was 0.94 (p < 0.001) in CHB validation set and 0.90 (<0.001) in non-CHB validation set. When the cut-off value was chosen as −1.048, the sensitivity and specificity in diagnosing GOV in CHB population were 89.1% and 82.5%, respectively. Importantly, the new algorithm accurately predicted the variceal hemorrhage not only in CHB patients, but also in patients with other CLDs. Conclusion: The new algorithm is regarded as a reliable model to prognosticate varices and variceal hemorrhage, and stratified not only the high-risk CHB patients, but also in patients with other CLDs for developing GOV and variceal bleeding.http://www.sciencedirect.com/science/article/pii/S1665268120300053Chronic hepatitis BGastroesophageal varicesAlgorithmVariceal hemorrhage |
| spellingShingle | Jia-li Ma Ling-ling He Yu Jiang Jun-ru Yang Ping Li Yao Zang Hong-shan Wei New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease Annals of Hepatology Chronic hepatitis B Gastroesophageal varices Algorithm Variceal hemorrhage |
| title | New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease |
| title_full | New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease |
| title_fullStr | New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease |
| title_full_unstemmed | New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease |
| title_short | New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease |
| title_sort | new model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease |
| topic | Chronic hepatitis B Gastroesophageal varices Algorithm Variceal hemorrhage |
| url | http://www.sciencedirect.com/science/article/pii/S1665268120300053 |
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