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 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.
['Ma|Jia-Li|JL|', 'He|Ling-Ling|LL|', 'Jiang|Yu|Y|', 'Yang|Jun-Ru|JR|', 'Li|Ping|P|', 'Zang|Yao|Y|', 'Wei|Hong-Shan|HS|']
D000328:Adult D000465:Algorithms D019540:Area Under Curve D002681:China D054459:Elasticity Imaging Techniques D016145:Endoscopy, Digestive System D004932:Esophageal and Gastric Varices D005260:Female D006471:Gastrointestinal Hemorrhage D019694:Hepatitis B, Chronic D006801:Humans D008103:Liver Cirrhosis D008107:Liver Diseases D016015:Logistic Models D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D009929:Organ Size D012372:ROC Curve D015203:Reproducibility of Results D012189:Retrospective Studies D013154:Spleen
Gastroesophageal varices Variceal hemorrhage Algorithm Chronic hepatitis B