ArticleJGH open : an open access journal of gastroenterology and hepatology2025
A Sequential Combination of Baveno VI Criteria With Spleen Stiffness Measurement Improves the Screening of High-Risk Esophageal Varices in Compensated Advanced Chronic Liver Disease.
Article in JGH open : an open access journal of gastroenterology and hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Diagnostic accuracy of non-invasive tools to detect esophageal varices keeping esophagogastroduodenoscopy as gold standard in patients with compensated chronic liver disease.Pakistan journal of medical sciences · 2026Article
- The emerging role of the PLiST model in acute-on-chronic liver failure.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- A Sequential Combination of Baveno VI Criteria With Spleen Stiffness Measurement Improves the Screening of High-Risk Esophageal Varices in Compensated Advanced Chronic Liver Disease.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
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3 authors.
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Abstract
Background: Detecting high-risk esophageal varices (HRV) in cirrhotic patients is crucial for intervention and preventing variceal bleeding. While endoscopy is the gold standard for diagnosis, it is invasive and carries risks. Spleen stiffness measurement (SSM) may improve HRV screening and increase the spared endoscopy rate (SER). Methods: We enrolled 129 patients with compensated advanced chronic liver disease (cACLD) who were candidates for variceal screening based on Baveno VI criteria (transient elastography ≥ 20 kPa or platelet count ≤ 150 × 10 Result: Ninety-two patients met the inclusion criteria. Alcohol was the most common etiology (32.6%). HRVs were found in 33 patients (35.9%). The AUROC values for SSM100Hz, SSM50Hz, Aspartate aminotransferase to Platelet Ratio Index (APRI), the combination of APRI and Fibrosis-4 (FIB-4), and FIB-4 were 0.807, 0.775, 0.753, 0.740, and 0.715, respectively. With a cutoff of 40 kPa, SSM100Hz showed a sensitivity of 97%, specificity of 45.8%, PPV of 50%, and NPV of 96.4%. The SER and missed HRV rate were 31.5% and 3%, respectively. The cutoff values for the greatest diagnostic accuracy in predicting HRV were 52.4 kPa for SSM50Hz, 0.98 for APRI, and 5.44 for FIB-4. Conclusion: The sequential combination of Baveno VI with SSM100Hz improves HRV screening and SER. The SSM100Hz demonstrates the highest diagnostic accuracy with a low missed HRV rate of < 5%.
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