ArticleDigestive diseases and sciences2016
Facility- and Patient-Level Factors Associated with Esophageal Variceal Screening in the USA.
Article in Digestive diseases and sciences, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- Utilization of the Disease Severity Index (DSI) from the HepQuant DuO Test Enhances Clinical Decision Making in Compensated Advanced Chronic Liver Disease.Journal of clinical medicine · 2026Article
- Spleen stiffness determined by spleen-dedicated device accurately predicted esophageal varices in cirrhosis patients.Therapeutic advances in chronic disease · 2023Article
- [Noninvasive assessment of the risk of esophageal variceal bleeding from noncirrhotic portal hypertension].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Ethnic Minorities and Low Socioeconomic Status Patients With Chronic Liver Disease Are at Greatest Risk of Being Uninsured.Gastroenterology research · 2021Article
- Gastrointestinal endoscopy in cirrhotic patient: Issues on the table.World journal of gastrointestinal endoscopy · 2021Review
- CON: Noninvasive Modalities Are Preferred to Screen for the Diagnosis of Esophageal and Gastric Varices When the Diagnosis of Cirrhosis Is Made.Clinical liver disease · 2020Review
- Racial disparities of Black Americans hospitalized for decompensated liver cirrhosis.BMC gastroenterology · 2020Article
- African-Americans with Cirrhosis Are Less Likely to Receive Endoscopic Variceal Screening Within One Year of Cirrhosis Diagnosis.Journal of racial and ethnic health disparities · 2018Article
- Adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage.World journal of gastrointestinal surgery · 2018Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimThe American Association for the Study of Liver Disease (AASLD) recommends screening for esophageal varices (EV) by esophagoduodenoscopy (EGD) in patients with cirrhosis to guide decisions regarding primary prophylaxis for EV hemorrhage. We aimed to identify patient and facility factors associated with EV screening in veterans with hepatitis C (HCV)-associated cirrhosis.
methodsThis was a population-based cohort study. Veterans with HCV and newly diagnosed cirrhosis between 1/1/2004 and 12/31/2005 and followed until 12/31/2011 were included. The primary outcome was receipt of EGD within 1 year of cirrhosis diagnosis. Patient- and facility-level factors associated with EV screening were determined.
resultsA total of 4230 patients with HCV cirrhosis were identified. During median follow-up of 6.1 years (IQR: 4.0-8.0), 21.5 % developed a decompensating event, and 38.3 % died. Fifty-four percent received an EGD, and 33.8 % had an EGD within guidelines. Median time from cirrhosis diagnosis to EGD was 72 days (IQR: 12-176). Factors independently associated with receipt of EV screening were a decompensation event (OR 1.16, CI 1.01-1.32) and gastroenterology/hepatology clinic access (OR 2.1, CI 1.73-2.46), whereas cardiovascular (OR 0.81, CI 0.69-0.95), mental health (OR 0.79, CI 0.68-0.91), and respiratory (OR 0.85, CI 0.72-0.99) comorbidities were associated with reduced likelihood of EV screening.
conclusionEV screening per AASLD guidelines occurs in only one-third of patients. This missed opportunity was strongly associated with access to gastroenterology/hepatology specialty care. Additionally, providers may be relying on clinical cues (i.e., decompensation) to prompt referral for endoscopy suggesting education to improve compliance with guidelines is needed.
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Registered trials
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