ArticleWorld journal of gastroenterology2013
Noninvasive methods for prediction of esophageal varices in pediatric patients with portal hypertension.
Article in World journal of gastroenterology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Platelet count, spleen length, and platelet count-to-spleen length ratio for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis.The Cochrane database of systematic reviews · 2017Pooled it
- Analysis of portal vein thrombosis prevalence and risk factors in neonates following umbilical venous catheterization: a systematic review and meta-analysis.Jornal de pediatriaPooled it
- Soluble CD163 for Prediction of High-Risk Esophageal Varices and Variceal Hemorrhage in Patients with Liver Cirrhosis.GE Portuguese journal of gastroenterology · 2022Article
- Von Willebrand factor and esophageal varices in children with chronic liver diseases.Clinical and experimental hepatology · 2021Article
- Noninvasive markers for esophageal varices in children with cirrhosis.Clinical and experimental pediatrics · 2021Article
- Fibrosis index predicts variceal bleeding and reduces need for nonselective beta-blocker in compensated cirrhosis with initial small esophageal varices without red-color sign.Annals of translational medicine · 2020Article
- A review of long-term outcome and quality of life of patients after Kasai operation surviving with native livers.Pediatric surgery international · 2017Review
- Can platelet count/spleen diameter ratio be used for cirrhotic children to predict esophageal varices?World journal of hepatology · 2016Article
- Diagnosing native liver fibrosis and esophageal varices using liver and spleen stiffness measurements in biliary atresia: a pilot study.Pediatric radiology · 2016Article
- Screening and Prophylaxis for Varices in Children with Liver Disease.Current gastroenterology reports · 2015Review
- Cost-effectiveness analysis of beta-blockers vs endoscopic surveillance in patients with cirrhosis and small varices.World journal of gastroenterology · 2014Article
- Non-Invasive Predictors for the First Variceal Hemorrhage in Children With Biliary Atresia After Kasai Portoenterostomy.Journal of clinical and experimental hepatologyArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo evaluate clinical and laboratory parameters for prediction of bleeding from esophageal varices (EV) in children with portal hypertension.
methodsRetrospective study of 103 children (mean age: 10.1 ± 7.7 years), 95.1% with intrahepatic portal hypertension. All patients had no history of bleeding and underwent esophagogastroduodenoscopy for EV screening. We recorded variceal size (F1, F2 and F3), red-color signs and portal gastropathy, according to the Japanese Research Society for Portal Hypertension classification. Patients were classified into two groups: with and without EV. Seven noninvasive markers were evaluated as potential predictors of EV: (1) platelet count; (2) spleen size z score, expressed as a standard deviation score relative to normal values for age; (3) platelet count to spleen size z score ratio; (4) platelets count to spleen size (cm) ratio; (5) the clinical prediction rule (CPR); (6) the aspartate aminotransferase to platelet ratio index (APRI); and (7) the risk score.
resultsSeventy-one children had EV on first endoscopy. On univariate analysis, spleen size, platelets, CPR, risk score, APRI, and platelet count to spleen size z score ratio showed significant associations. The best noninvasive predictors of EV were platelet count [area under the receiver operating characteristic curve (AUROC) 0.82; 95%CI: 0.73-0.91], platelet: spleen size z score (AUROC 0.78; 95%CI: 0.67-0.88), CPR (AUROC 0.77; 95%CI: 0.64-0.89), and risk score (AUROC 0.77; 95%CI: 0.66-0.88). A logistic regression model was applied with EV as the dependent variable and corrected by albumin, bilirubin and spleen size z score. Children with a CPR < 114 were 20.7-fold more likely to have EV compared to children with CPR > 114. A risk score > -1.2 increased the likelihood of EV (odds ratio 7.47; 95%CI: 2.06-26.99).
conclusionChildren with portal hypertension with a CPR below 114 and a risk score greater than -1.2 are more likely to have present EV. Therefore, these two tests can be helpful in selecting children for endoscopy.
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