Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;66(4):1343-1348.
doi: 10.1007/s10620-020-06334-y. Epub 2020 May 21.

Validation of the Expanded Baveno-VI Criteria for Screening Gastroscopy in Asian Patients with Compensated Advanced Chronic Liver Disease

Pik-Eu Chang  1 , Chee-Kiat Tan  1 , Chang-Chuen Cheah  1 , Weiquan Li  2 , Wan Cheng Chow  1 , Yu-Jun Wong  3
Affiliations

Validation of the Expanded Baveno-VI Criteria for Screening Gastroscopy in Asian Patients with Compensated Advanced Chronic Liver Disease

Pik-Eu Chang et al. Dig Dis Sci. 2021 Apr.

Abstract

Background: The expanded Baveno-VI criteria may further reduce the need for screening gastroscopy compared to Baveno-VI criteria.

Aim: We sought to validate the performance of these criteria in a cohort of compensated advanced chronic liver disease (cACLD) patients with predominantly hepatitis B infection.

Methods: Consecutive cACLD patients from 2006 to 2012 with paired liver stiffness measurements and screening gastroscopy within 1 year were included. The expanded Baveno-VI criteria were applied to evaluate the sensitivity (SS), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) for the presence of high-risk varices (HRV).

Results: Among 165 cACLD patients included, 17 (10.3%) had HRV. The commonest etiology of cACLD was chronic hepatitis B (36.4%) followed by NAFLD (20.0%). Application of expanded Baveno-VI criteria avoided more screening gastroscopy (43.6%) as compared to the original Baveno-VI criteria (18.8%) without missing more HRV (1 with both criteria). The overall SS, SP, PPV and NPV of the expanded Baveno-VI criteria in predicting HRV were 94.1%, 48.0%, 17.2% and 98.6%, respectively.

Conclusion: Application of the expanded Baveno-VI criteria can safely avoid screening gastroscopy in 43.6% of cACLD patients with an excellent ability to exclude HRV.

Keywords: Esophageal and gastric varices; Gastroscopy; Hypertension, Portal; Liver cirrhosis.

PubMed Disclaimer

References

    1. D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis A systematic review of 118 studies. J Hepatol. 2006;44:217–231. - DOI
    1. Pagliaro L, D’Amico G, Pasta L, et al. Portal hypertension in cirrhosis: natural history. In: Bosch J, Groszmann RJ, eds. Portal hypertension. Pathophysiology and treatment. Oxford: Blackwell Scientific; 1994:72–92.
    1. Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis and management: 2016 Practice Guidance by the American Association for Study of Liver Diseases. Hepatology. 2017;65:310–335. - DOI
    1. Grace ND. Diagnosis and treatment of gastrointestinal bleeding secondary to portal hypertension. American College of Gastroenterology Practice Parameters Committee. Am J Gastroenterol. 1997;92:1081–1091. - PubMed
    1. D’Amico G, de Franchis R. Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators. Hepatology. 2003;38:599–612. - DOI

Publication types

LinkOut - more resources