Año 2017 / Volumen 109 / Número 10
Original
The Baveno VI criteria for predicting esophageal varices: validation in real life practice

704-707

DOI: 10.17235/reed.2017.5052/2017

Mafalda Sousa, Sónia Fernandes, Luísa Proença, Ana Paula Silva, Sónia Leite, Joana Silva, Ana Ponte, Jaime Rodrigues, João Carlos Silva, João Carvalho,

Resumen
Background and aims: According to the Baveno VI consensus, patients with liver stiffness < 20 kPa and a platelet count > 150,000 ul have very low risk of clinically significant varices and do not need a screening endoscopy. The aim of this study was to evaluate non-invasive methods as predictors of esophageal varices according to the Baveno VI recommendations, in real life clinical practice. Methods: Retrospective evaluation of patients with chronic liver disease who underwent transient elastography between January 2013 and December 2015. Results: One hundred and four patients were included in the study, the median age was 56.8 years and 69.2% were male. The etiology of liver disease was hepatitis C in 80% of patients (including 20% with HIV co-infection), alcohol in 12%, hepatitis B in 4% and other causes in 5%. Varices were present in 25% of patients. A liver stiffness < 20 kPa had a sensitivity of 92.3% and a specificity of 84.6%. When considering high risk varices (small with red wales or large varices), a liver stiffness < 20 kPa had 100% sensitivity. A platelet count > 150,000/l had a sensitivity of 84.6% and a specificity of 64.1%. Four patients with a platelet count (PLT) > 150,000/l had esophageal varices. When both criteria were applied to the patient cohort, according to the Baveno VI consensus, the sensitivity was 100% and the specificity, 61.5%. Conclusion: In this study, the Baveno VI criteria had 100% sensitivity but a relatively low specificity for the non-invasive diagnosis of esophageal varices. In clinical practice, all patients with varices are identified but many patients have a subsequent negative endoscopy.
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Sousa M, Fernandes S, Proença L, Silva A, Leite S, Silva J, et all. The Baveno VI criteria for predicting esophageal varices: validation in real life practice. 5052/2017


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Ficha Técnica

Recibido: 11/05/2017

Aceptado: 26/06/2017

Prepublicado: 04/08/2017

Publicado: 29/09/2017

Tiempo de revisión del artículo: 41 días

Tiempo de prepublicación: 85 días

Tiempo de edición del artículo: 141 días


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