Prediction of high-risk esophageal varices in patients with compensated cirrhosis using albumin-bilirubin-platelet score

Eur J Gastroenterol Hepatol. 2022 Mar 1;34(3):332-337. doi: 10.1097/MEG.0000000000002270.

Abstract

Background: Despite the fact that endoscopy is the gold standard for screening of high-risk varices (HRVs) in patients with compensated cirrhosis, it is invasive, costly and not necessary for all patients. So, noninvasive tests can replace endoscopy. We aimed at evaluating the albumin-bilirubin-platelet (ALBL-PLT) score as a noninvasive test in predicting HRVs in compensated cirrhotic patients versus Baveno VI and extended Baveno VI criteria.

Methods: patients with compensated cirrhosis (n = 204) were included. Laboratory parameters, esophagogastroduodenoscopy (EGD) and liver stiffness measurement by transient elastography were done. Classification of patients according to the status of HRVs was done. We compared both groups on the basis of ALBL-PLT score, Baveno VI and extended Baveno VI criteria.

Results: Among the total patients, 96/204 (47%) patients had HRVs. They have higher liver stiffness measurement than those without HRVs (33 ± 13.1 versus 19.3 ± 8.25, CI, -19.94, -7.31, P value <0.001). Also, all HRVs patients have an ALBL-PLT score of more than 3. The area under the receiver operating characteristic curve for the ALBL-PLT score is higher than that for Baveno VI and extended Baveno VI criteria (0.894 versus 0.722 and 0.792, respectively).

Conclusion: ALBL-PLT score of more than three has a good predictive value in predicting HRVs among compensated cirrhotic patients.

MeSH terms

  • Albumins
  • Bilirubin
  • Elasticity Imaging Techniques*
  • Esophageal and Gastric Varices* / diagnosis
  • Esophageal and Gastric Varices* / etiology
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Platelet Count

Substances

  • Albumins
  • Bilirubin