A Simple Noninvasive Score Predicts Gastroesophageal Varices in Patients With Chronic Viral Hepatiti

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J Clin Gastroenterol. 2008 Jun 16. [Epub ahead of print]

A Simple Noninvasive Score Predicts Gastroesophageal Varices in Patients With

Chronic Viral Hepatitis.

Gentile I, Viola C, Graf M, Liuzzi R, Quarto M, Cerini R, Piazza M, Borgia G.

*Department of Public Medicine and Social Security, Section of Infectious

Diseases †Institution of Biostructure and Bioimaging, National Research Council

(CNR), via S. Pansini, Naples, Italy ‡Department of Physical Science, University

of Naples “Federico II”

BACKGROUND: Guidelines recommend upper endoscopic screening of cirrhotic

patients for gastroesophageal varices. Cirrhosis is not always distinguishable

from chronic hepatitis. GOALS: To identify low-risk patients who can be spared

upper endoscopy irrespective of a diagnosis of cirrhosis. STUDY: We evaluated 13

nonendoscopic variables as predictors of esophagogastric varices in 254 patients

with hepatitis B or hepatitis C-related chronic liver disease who underwent

upper endoscopy. RESULTS: Any size varices occurred in 30.3% (77/254), and large

varices in 12.2% of patients (31/254). Age>50 years [odds ratio (OR): 11.29; 95%

confidence interval (CI): 2.33-54.67], platelet count 1 (OR: 2.83; 95% CI:

1.26-6.34) independently predicted varices by logistic regression. Using a score

based on age>50 years, platelets 1 (1 point/predictor), only 3.2% of patients

with a score

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