Author | Castro Filho, Élio C. | |
Author | Fernandes, Flávia F. | |
Author | Villela-Nogueira, Cristiane | |
Author | Madeira, Eduardo | |
Author | Barros, Fernando | |
Author | Luz, Rodrigo | |
Author | Pereira, Gustavo Henrique | |
Author | Perazzo, Hugo | |
Access date | 2023-08-30T23:53:34Z | |
Available date | 2023-08-30T23:53:34Z | |
Document date | 2023 | |
Citation | CASTRO FILHO, Élio C. et al. Validation of the Baveno VI criteria to rule out high-risk varices using hepatic shear-wave elastography. European Journal of Gastroenterology & Hepatology, v. 35, n. 5, p. 559-567, May 2023. | en_US |
ISSN | 0954-691X | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/60273 | |
Sponsorship | This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) - Finance Code 001 (grant number 88882.443006/2019-01 for ECCF) and supported by funding from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (grant number E-26/201.351/2021 for HP]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. | en_US |
Language | eng | en_US |
Publisher | Lippincott Williams And Wilkins | en_US |
Rights | restricted access | en_US |
Title | Validation of the Baveno VI criteria to rule out high-risk varices using hepatic shear-wave elastography | en_US |
Type | Article | en_US |
DOI | 10.1097/MEG.0000000000002507 | |
Abstract | Introduction and objectives: Liver stiffness measurement (LSM) by transient elastography has been validated to predict high-risk varices (HRV). We aimed to evaluate the accuracy of shear-wave elastography (SWE) and platelet count (Baveno VI criteria) to rule out HRV in patients with compensated advanced chronic liver disease (c-ACLD). Methods: This retrospective study analyzed data of patients with c-ACLD (transient elastography ≥ 10 kPa) submitted to two-dimensional SWE (2D-SWE) (GE-LOGIQ-S8) and/or point SWE (p-SWE) (ElastPQ) who had a gastrointestinal endoscopy within 24 months. HRV definition was a large size and presence of red wale marks or sequelae from previous treatment. Optimal thresholds of SWE systems for HRV were identified. The proportion of spared gastrointestinal endoscopies and missing HRV considering a favorable SWE Baveno VI criteria were assessed. Results: Eighty patients [36% male, median age = 63 (interquartile range, 57-69) years] were included. The prevalence of HRV was 34% ( n = 27/80). The optimal thresholds to predict HRV were 10 kPa and 12 kPa for 2D-SWE and p-SWE, respectively. A favorable 2D-SWE Baveno VI criteria (LSM < 10 kPa and platelets count > 150 × 10 9 /mm 3 ) avoided 19% of gastrointestinal endoscopies without missing HRVs. A favorable p-SWE Baveno VI criteria (LSM < 12 kPa and platelets count > 150 × 10 9 /mm 3 ) spared 20% of gastrointestinal endoscopy without missing HRVs. Using a lower threshold of platelet count (<110 × 10 9 /mm 3 , expanded Baveno VI), 2D-SWE (<10 kPa) avoided 33% of gastrointestinal endoscopy with 8% of missing HRVs, while p-SWE (<12 kPa) avoided 36% of gastrointestinal endoscopy with 5% of missing HRVs. Conclusion: LSM by p-SWE or 2D-SWE combined with platelet count (Baveno VI criteria) can spare a considerable number of gastrointestinal endoscopies missing a negligible proportion of HRV. | en_US |
Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Gastroenterology and Hepatology Department. Bonsucesso Federal Hospital. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. School of Medicine, Internal Medicine Department. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. School of Medicine, Internal Medicine Department. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Gastroenterology and Hepatology Department. Bonsucesso Federal Hospital. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil. | en_US |
Subject | Liver stiffness measurement (LSM) | en_US |
Subject | High-risk varices (HRV) | en_US |
Subject | Baveno VI criteria | en_US |
Subject | Advanced chronic liver disease (c-ACLD) | en_US |
e-ISSN | 1473-5687 | |
Embargo date | 2030-12-31 | |