Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage

Background: Esophageal variceal (EV) hemorrhage is a life-threatening consequence of portal hypertension in cirrhotic patients. Screening upper endoscopy and endoscopic variceal ligation to identify and treat EVs have contraindications, complications, and high costs. We sought to identify non-invasi...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Shasha Li, Peng Huang, Andre J. Jeyarajan, Chao Ma, Ke Zhu, Chuanlong Zhu, Ning Jiang, Ming Li, Tuo Shao, Mingfeng Han, Lin Tan, Wenyu Lin
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	esophageal varices (EVs) liver fibrosis hemorrhage Golgi protein 73 (GP73) population cohort study Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/138c8fddc2da498d98576b9ad9f78fc9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:138c8fddc2da498d98576b9ad9f78fc9
record_format	dspace
spelling	oai:doaj.org-article:138c8fddc2da498d98576b9ad9f78fc92021-12-02T00:28:29ZAssessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage2296-858X10.3389/fmed.2021.770836https://doaj.org/article/138c8fddc2da498d98576b9ad9f78fc92021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.770836/fullhttps://doaj.org/toc/2296-858XBackground: Esophageal variceal (EV) hemorrhage is a life-threatening consequence of portal hypertension in cirrhotic patients. Screening upper endoscopy and endoscopic variceal ligation to identify and treat EVs have contraindications, complications, and high costs. We sought to identify non-invasive tests (NITs) as alternatives to endoscopic EV screening.Methods: In this case-control study, we retrospectively analyzed 286 cirrhotic patients treated for EVs at the Second People's Hospital of Fuyang City, China from January to December 2019. We applied ROC curve analysis to assess the accuracy of various NITs in predicting EV hemorrhage.Results: There were significant differences between the hemorrhage and non-hemorrhage groups in median serum albumin (ALB) (p < 0.001), median bilirubin (TBIL) (p < 0.046), prothrombin (PT) time (p < 0.001), Golgi protein 73 (GP73; p = 0.012) and Child-Pugh (C-P) scores (p < 0.001). For ALB (cutoff <33.2g/L), PT time (cutoff > 14.2 seconds), GP73 (cutoff > 126.4 ng/ml), and C-P scores, the areas under the ROC curves (AUCs) were 73.4% (95% CI: 67.5–79.2), 68.6% (95% CI: 62.4–74.8), 62.2% (95% CI: 52.8–71.5) and 69.8% (95%CI: 63.8–75.8), respectively, with corresponding sensitives of 71.5, 59.8, 69.8, and 92.2% and specificities of 65.6%, 70.1%, 56.5%, and 38.6%. When ALB was combined with GP73, the AUC was 74.3% (95% CI: 66.1–82.5) with a sensitivity of 65.1% and specificity of 76.5%. When ALB, PT, and C-P scores were combined, the AUC was 76.5% (95% CI: 70.9–82.1) with a sensitivity of 79.5% and specificity of 64.3%. When ALB, PT, GP73, and C-P scores were combined, the AUC was 75.2% (95% CI: 67.3–83.1) with a sensitivity of 54.0% and specificity of 86.9%.Conclusion: ALB, TBIL, GP73, and C-P scores, may be used to predict EV hemorrhage in cirrhotic patients. The combination of multiple NITs is better than a single index and can increase diagnostic performance.Shasha LiPeng HuangPeng HuangAndre J. JeyarajanChao MaKe ZhuChuanlong ZhuNing JiangMing LiTuo ShaoMingfeng HanLin TanWenyu LinFrontiers Media S.A.articleesophageal varices (EVs)liver fibrosishemorrhageGolgi protein 73 (GP73)population cohort studyMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	esophageal varices (EVs) liver fibrosis hemorrhage Golgi protein 73 (GP73) population cohort study Medicine (General) R5-920
spellingShingle	esophageal varices (EVs) liver fibrosis hemorrhage Golgi protein 73 (GP73) population cohort study Medicine (General) R5-920 Shasha Li Peng Huang Peng Huang Andre J. Jeyarajan Chao Ma Ke Zhu Chuanlong Zhu Ning Jiang Ming Li Tuo Shao Mingfeng Han Lin Tan Wenyu Lin Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage
description	Background: Esophageal variceal (EV) hemorrhage is a life-threatening consequence of portal hypertension in cirrhotic patients. Screening upper endoscopy and endoscopic variceal ligation to identify and treat EVs have contraindications, complications, and high costs. We sought to identify non-invasive tests (NITs) as alternatives to endoscopic EV screening.Methods: In this case-control study, we retrospectively analyzed 286 cirrhotic patients treated for EVs at the Second People's Hospital of Fuyang City, China from January to December 2019. We applied ROC curve analysis to assess the accuracy of various NITs in predicting EV hemorrhage.Results: There were significant differences between the hemorrhage and non-hemorrhage groups in median serum albumin (ALB) (p < 0.001), median bilirubin (TBIL) (p < 0.046), prothrombin (PT) time (p < 0.001), Golgi protein 73 (GP73; p = 0.012) and Child-Pugh (C-P) scores (p < 0.001). For ALB (cutoff <33.2g/L), PT time (cutoff > 14.2 seconds), GP73 (cutoff > 126.4 ng/ml), and C-P scores, the areas under the ROC curves (AUCs) were 73.4% (95% CI: 67.5–79.2), 68.6% (95% CI: 62.4–74.8), 62.2% (95% CI: 52.8–71.5) and 69.8% (95%CI: 63.8–75.8), respectively, with corresponding sensitives of 71.5, 59.8, 69.8, and 92.2% and specificities of 65.6%, 70.1%, 56.5%, and 38.6%. When ALB was combined with GP73, the AUC was 74.3% (95% CI: 66.1–82.5) with a sensitivity of 65.1% and specificity of 76.5%. When ALB, PT, and C-P scores were combined, the AUC was 76.5% (95% CI: 70.9–82.1) with a sensitivity of 79.5% and specificity of 64.3%. When ALB, PT, GP73, and C-P scores were combined, the AUC was 75.2% (95% CI: 67.3–83.1) with a sensitivity of 54.0% and specificity of 86.9%.Conclusion: ALB, TBIL, GP73, and C-P scores, may be used to predict EV hemorrhage in cirrhotic patients. The combination of multiple NITs is better than a single index and can increase diagnostic performance.
format	article
author	Shasha Li Peng Huang Peng Huang Andre J. Jeyarajan Chao Ma Ke Zhu Chuanlong Zhu Ning Jiang Ming Li Tuo Shao Mingfeng Han Lin Tan Wenyu Lin
author_facet	Shasha Li Peng Huang Peng Huang Andre J. Jeyarajan Chao Ma Ke Zhu Chuanlong Zhu Ning Jiang Ming Li Tuo Shao Mingfeng Han Lin Tan Wenyu Lin
author_sort	Shasha Li
title	Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage
title_short	Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage
title_full	Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage
title_fullStr	Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage
title_full_unstemmed	Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage
title_sort	assessment of non-invasive markers for the prediction of esophageal variceal hemorrhage
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/138c8fddc2da498d98576b9ad9f78fc9
work_keys_str_mv	AT shashali assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT penghuang assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT penghuang assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT andrejjeyarajan assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT chaoma assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT kezhu assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT chuanlongzhu assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT ningjiang assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT mingli assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT tuoshao assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT mingfenghan assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT lintan assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage AT wenyulin assessmentofnoninvasivemarkersforthepredictionofesophagealvaricealhemorrhage
_version_	1718403659840094208

Assessment of Non-invasive Markers for the Prediction of Esophageal Variceal Hemorrhage

Ejemplares similares