Non-invasive predictors of esophageal varices with a high risk of bleeding in pediatric cirrhotic patients

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dc.creatorJosé Ricardoborém Lopes
dc.creatorLucas Garcia de Figueiredo Colin
dc.creatorAlexandre Rodrigues Ferreira
dc.creatorPriscila Menezes Ferri Liu
dc.creatorThaís Costa Nascentes Queiroz
dc.creatorEleonora Druve Tavares Fagundes
dc.creatorJúlio Rocha Pimenta
dc.creatorJosé Andrade Franco Neto
dc.creatorSimone Diniz Carvalho
dc.creatorMaria Eduarda Marques Borges
dc.date.accessioned2023-07-28T23:43:18Z
dc.date.accessioned2025-09-09T01:01:44Z
dc.date.available2023-07-28T23:43:18Z
dc.date.issued2020
dc.format.mimetypepdf
dc.identifier.doi10.1097/mpg.0000000000003039
dc.identifier.issn02772116
dc.identifier.urihttps://hdl.handle.net/1843/57191
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofJournal of Pediatric Gastroenterology and Nutrition
dc.rightsAcesso Aberto
dc.subjectCrianças
dc.subjectVarizes Esofágicas e Gástricas
dc.subjectCirrose Hepática
dc.subject.otherChildren
dc.subject.otherEsophageal varices
dc.subject.otherLiver cirrhosis
dc.titleNon-invasive predictors of esophageal varices with a high risk of bleeding in pediatric cirrhotic patients
dc.typeArtigo de periódico
local.citation.epage806
local.citation.issue72
local.citation.spage802
local.description.resumoObjectives: 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.
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIA
local.publisher.initialsUFMG
local.url.externahttps://journals.lww.com/jpgn/Fulltext/2021/06000/Non_invasive_Predictors_of_Esophageal_Varices_With.5.aspx

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