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https://wslhd.intersearch.com.au/wslhdjspui/handle/1/9535
Title: | Validation and comparison of non-invasive tests for the exclusion of high-risk varices in compensated advanced chronic liver disease |
Authors: | Kurup, Rajiv;Kalo, Eric;Read, Scott A.;Ma, Wai See;George, Jacob;Ahlenstiel, Golo |
WSLHD Author: | Kurup, Rajiv;Kalo, Eric;Read, Scott A.;Ma, Wai See;George, Jacob;Ahlenstiel, Golo |
Subjects: | Gastroenterology |
Issue Date: | 2024 |
Citation: | Livers 4(2):182-192, 2024 |
Abstract: | Non-invasive tests (NITs) are a potential alternative to screening oesophagogastroduodenoscopy (OGD) for ruling out high-risk varices (HRVs) in patients with compensated advanced chronic liver disease (cACLD). This retrospective study aimed to externally validate and compare various NITs in a multi-centre Australian cohort. Patients with cACLD were enrolled between January 2013 and December 2022. Liver stiffness measurements (LSMs), clinicopathological data, and OGD results were collected. A total of 210 patients were included. The median age was 57 years and 65.7% were male. The main aetiology of cACLD was hepatitis C (41.9%), and 91.9% of patients were Child�Pugh A. HRV prevalence was 12.4%. The Baveno VI criteria (B6C) was the only NIT that could safely reduce the need for OGDs across all aetiologies of cACLD, with a negative predictive value of 98.6 and spared OGD in 33.8%. The FIB-4 would have avoided the most OGDs (71%); however, the HRV miss rate was 6%. The results suggest that the B6C is the best performing NIT in our cohort and reliably excludes HRVs in cACLD patients, regardless of aetiology. This study confirms that the Baveno VI criteria can be applied in an Australian, mixed aetiology cohort to avoid unnecessary screening OGD. |
URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/9535 |
DOI: | https://doi.org/10.3390/livers4020014 |
Journal: | Livers |
Type: | Journal Article |
Study or Trial: | Multicentre Study Retrospective Study |
Department: | General Medicine Gastroenterology and Hepatology Immunology |
Facility: | Blacktown Westmead Auburn |
Affiliated Organisations: | Blacktown Clinical School and Research Centre, School of Medicine, Western Sydney University, Blacktown, NSW, Australia Blacktown Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia Storr Liver Centre, The Westmead Institute for Medical Research, Sydney, NSW, Australia University of Sydney, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia |
Keywords: | liver disease variceal bleeding cirrhosis oesophagogastroduodenoscopy |
Appears in Collections: | Blacktown Mount Druitt Hospital |
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