Portal de investigação
Performance of spleen stiffness measurement to rule out high-risk varices in patients with porto-sinusoidal vascular disorder
Autores da FMUP
Participantes de fora da FMUP
- Moga, Lucile
- Paradis, Valerie
- Ferreira-Silva, Joel
- Gudavalli, Koushik
- Indulti, Federica
- Dajti, Elton
- Nicoara-Farcau, Oana
- Tosetti, Giulia
- Antonenko, Antonina
- Fodor, Andreea
- Vidal-Gonzalez, Judit
- Turco, Laura
- Capinha, Francisco
- Elkrief, Laure
- Monllor-Nunell, Teresa
- Goria, Odile
- Balcar, Lorenz
- Lannes, Adrien
- Mallet, Vincent
- Poujol-Robert, Armelle
- Thabut, Dominique
- Houssel-Debry, Pauline
- Wong, Yu Jun
- Ronot, Maxime
- Vilgrain, Valerie
- Rampally, Sai Prasanth
- Payance, Audrey
- Castera, Laurent
- Reiberger, Thomas
- Ferrusquia-Acosta, Jose
- Noronha Ferreira, Carlos
- Vitale, Giovanni
- Simon-Talero, Macarena
- Procopet, Bogdan
- Berzigotti, Annalisa
- Caccia, Riccardo
- Turon, Fanny
- Schepis, Filippo
- Ravaioli, Federico
- Colecchia, Antonio
- Valsan, Arun
- Plessier, Aurelie
- Rautou, Pierre-Emmanuel
- ERN RARE-LIVER
- VALDIG EASL Consortium
Unidades de investigação
Abstract
Background & Aims: Baveno VII consensus suggests that screening endoscopy can be spared in patients with compensated cirrhosis when spleen stiffness measurement (SSM) by vibration-controlled transient elastography (VCTE) is <= 40 kPa as they have a low probability of high-risk varices (HRV). Conversely, screening endoscopy is required in all patients with porto-sinusoidal vascular disorder (PSVD). This study aimed to evaluate the performance of SSM-VCTE to rule out HRV in patients with PSVD and signs of portal hypertension. Approach & results: We retrospectively included patients with PSVD, >= 1 sign of portal hypertension, without history of variceal bleeding, who underwent a SSM-VCTE within 2 years before or after an upper endoscopy in 21 VALDIG centers, divided into a derivation and a validation cohort. 154 patients were included in the derivation cohort; 43% had HRV. By multivariable logistic regression analysis, SSM-VCTE >40 kPa and serum bilirubin >= 1 mg/dL were associated with HRV. SSM-VCTE <= 40 kPa combined with bilirubin <1 mg/dL had a sensitivity of 96% to rule out HRV, and could spare 38% of screening endoscopies, with 4% of HRV missed, and a 95% negative predictive value (NPV). In the validation cohort, including 155 patients, SSM combined with bilirubin could spare 21% of screening endoscopies, with 4% of HRV missed and a 94% NPV. Conclusion: This study gathering a total of 309 PSVD patients showed that SSM-VCTE <= 40 kPa combined with bilirubin <1 mg/dL identifies patients with PSVD and portal hypertension with a probability of HRV <5%, in whom screening endoscopy can be spared.
Dados da publicação
- ISSN/ISSNe:
- 0270-9139, 1527-3350
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 38954825
- Link para outro recurso:
- www.scopus.com
Hepatology John Wiley and Sons Ltd
Citações Recebidas na Web of Science: 11
Citações Recebidas na Scopus: 10
Documentos
- Não há documentos
Filiações
Keywords
- porto-sinusoidal vascular disorder; high-risk varices; spleen stiffness measurement; portal hypertension
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Citar a publicação
Moga L,Paradis V,Ferreira J,Gudavalli K,Indulti F,Dajti E,Nicoara O,Tosetti G,Antonenko A,Fodor A,Vidal J,Turco L,Capinha F,Elkrief L,Monllor T,Goria O,Balcar L,Lannes A,Mallet V,Poujol A,Thabut D,Houssel P,Wong YJ,Ronot M,Vilgrain V,Rampally SP,Payance A,Castera L,Reiberger T,Ferrusquia J,Noronha C,Vitale G,Simon M,Procopet B,Berzigotti A,Caccia R,Turon F,Schepis F,Ravaioli F,Colecchia A,Valsan A,Macedo G,Plessier A,Rautou P,ERN R,VALDIG C. Performance of spleen stiffness measurement to rule out high-risk varices in patients with porto-sinusoidal vascular disorder. Hepatology. 2024. IF:13,500. (1).
