Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients

<i>Background:</i> Ascites and esophageal varices (EV) are the most common complications of portal hypertension, with an incidence of approximately 50%. Since effective preventive modalities have been established for variceal hemorrhage, early detection of EV is critical for primary prev...

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Main Authors: Vo Duy Thong, Ho Thi Van Anh
Format: Article
Language:English
Published: MDPI AG 2021-06-01
Series:Gastroenterology Insights
Subjects:
Online Access:https://www.mdpi.com/2036-7422/12/2/23
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author Vo Duy Thong
Ho Thi Van Anh
author_facet Vo Duy Thong
Ho Thi Van Anh
author_sort Vo Duy Thong
collection DOAJ
description <i>Background:</i> Ascites and esophageal varices (EV) are the most common complications of portal hypertension, with an incidence of approximately 50%. Since effective preventive modalities have been established for variceal hemorrhage, early detection of EV is critical for primary prevention of bleeding. Serum-ascites albumin gradient (SAAG) can be considered an indirect parameter for the detection of EV and is useful in regions where there is a shortage of human and material resources to perform upper gastrointestinal endoscopy (UGE)<b>.</b> The aim was to evaluate the role of serum-ascites albumin gradient (SAAG) in the prediction of esophageal varices (EV) in cirrhotic patients with ascites. <i>Methods:</i> All cirrhotic patients with ascites, identified by ultrasonography, who underwent measurement of SAAG, were included in this study. All patients underwent upper gastrointestinal endoscopy (UGE) for assessment of the presence and size of EV. <i>Results:</i> The study included 80 cirrhotic patients with ascites. The main causes of cirrhosis were alcohol intake (37.5%), hepatitis B virus (25.0%), and hepatitis C virus (15.0%). Patients with SAAG values > 1.75 g/dL demonstrated EV with a sensitivity and specificity of 78.4% and 83.3%, respectively. SAAG values > 1.8 g/dL were associated with the risk of large EV with AUC of 0.856, sensitivity of 88.24%, and specificity of 50.79%. The correlation coefficient (<i>r</i>) between SAAG and EV was 0.429, which was statistically significant (<i>p</i> < 0.001). <i>Conclusions:</i> Cirrhotic patients with SAAG values ≥ 1.8 have a higher risk of large EV. In particular, those with values > 1.9 who have higher possibility of bleeding must undergo upper GI endoscopy.
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spelling doaj.art-b4a19b7134604876b0836c11e61409372023-11-21T22:36:13ZengMDPI AGGastroenterology Insights2036-74142036-74222021-06-0112227027710.3390/gastroent12020023Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic PatientsVo Duy Thong0Ho Thi Van Anh1Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 72714, VietnamDepartment of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 72714, Vietnam<i>Background:</i> Ascites and esophageal varices (EV) are the most common complications of portal hypertension, with an incidence of approximately 50%. Since effective preventive modalities have been established for variceal hemorrhage, early detection of EV is critical for primary prevention of bleeding. Serum-ascites albumin gradient (SAAG) can be considered an indirect parameter for the detection of EV and is useful in regions where there is a shortage of human and material resources to perform upper gastrointestinal endoscopy (UGE)<b>.</b> The aim was to evaluate the role of serum-ascites albumin gradient (SAAG) in the prediction of esophageal varices (EV) in cirrhotic patients with ascites. <i>Methods:</i> All cirrhotic patients with ascites, identified by ultrasonography, who underwent measurement of SAAG, were included in this study. All patients underwent upper gastrointestinal endoscopy (UGE) for assessment of the presence and size of EV. <i>Results:</i> The study included 80 cirrhotic patients with ascites. The main causes of cirrhosis were alcohol intake (37.5%), hepatitis B virus (25.0%), and hepatitis C virus (15.0%). Patients with SAAG values > 1.75 g/dL demonstrated EV with a sensitivity and specificity of 78.4% and 83.3%, respectively. SAAG values > 1.8 g/dL were associated with the risk of large EV with AUC of 0.856, sensitivity of 88.24%, and specificity of 50.79%. The correlation coefficient (<i>r</i>) between SAAG and EV was 0.429, which was statistically significant (<i>p</i> < 0.001). <i>Conclusions:</i> Cirrhotic patients with SAAG values ≥ 1.8 have a higher risk of large EV. In particular, those with values > 1.9 who have higher possibility of bleeding must undergo upper GI endoscopy.https://www.mdpi.com/2036-7422/12/2/23SAAGesophageal varicescirrhosis
spellingShingle Vo Duy Thong
Ho Thi Van Anh
Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients
Gastroenterology Insights
SAAG
esophageal varices
cirrhosis
title Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients
title_full Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients
title_fullStr Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients
title_full_unstemmed Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients
title_short Prediction of Esophageal Varices Based on Serum-Ascites Albumin Gradient in Cirrhotic Patients
title_sort prediction of esophageal varices based on serum ascites albumin gradient in cirrhotic patients
topic SAAG
esophageal varices
cirrhosis
url https://www.mdpi.com/2036-7422/12/2/23
work_keys_str_mv AT voduythong predictionofesophagealvaricesbasedonserumascitesalbumingradientincirrhoticpatients
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