Non-invasive predictors of esophageal varices with a high risk of bleeding in pediatric cirrhotic patients
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Membros da banca
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Objectives: To evaluate non-invasive predictive factors of varices with a high risk of bleeding in pediatric cirrhotic patients.Methods: This retrospective, cross-sectional study included data from 158 children with cirrhosis, median age of 5.38 years (interquartile [IQ]2.0811.52 years), and no history of upper gastrointestinal bleeding.Patients underwent an endoscopy to screen for esophageal varices.
Varices with a high risk of bleeding were defined as those with a medium to large caliber, presence of red spots, or the presence of gastric varices and identified as high-risk varices (HRV). Laboratory and clinical factors were evaluated as possible predictors of HRV.
Results: HRV were detected in 30 children (19%) after the first endoscopy. In the multivariate analysis, only the risk score (RS), as described by Park et al, and the aspartate aminotransferase-to-platelet ratio index (APRi) were predictive of HRV. The best non-invasive predictor of HRV was the RS with an area under the receiver operating characteristic curve of 0.764. When used a cut-off point
of 1.2, the sensitivity of the RS was 90% and specificity was 53%. The use of RS or APRi correctly identified 96% of children with HRV. Conclusions: The described predictors allow the correct identification of patients with HRV. The association of RS >1.2 or APRi >1.4 has a good sensitivity to identify HRV and to prevent unnecessary endoscopy in about one-third of children with no HRV.
Abstract
Assunto
Crianças, Varizes Esofágicas e Gástricas, Cirrose Hepática
Palavras-chave
Children, Esophageal varices, Liver cirrhosis
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https://journals.lww.com/jpgn/Fulltext/2021/06000/Non_invasive_Predictors_of_Esophageal_Varices_With.5.aspx