studies

586A AASLD ABSTRACTS HEPATOLOGY, October, 2015
755
Transient Elastography and simple serological tests
as screening tools for esophageal varices in cirrhotic
patients
Simona Bota 1 , Mattias Mandorfer 1 , Remy Schwarzer 1 , Vlad F.
Iovanescu 2 , Philipp Schwabl 1 , Thomas Reiberger 1 , Michael
Trauner 1 , Arnulf Ferlitsch 1 , Markus Peck-Radosavljevic 1 ; 1 Gastroenterology
and Hepatology, Medical University of Vienna, Vienna,
Austria; 2 Gastroenterology and Hepatology, University of Medicine
and Pharmacy, Craiova, Romania
Background:Diagnosis of esophageal varices (EV) in cirrhotic
patients is crucial for timely initiation of prophylaxis of variceal
bleeding but requires upper GI endoscopy. Recently,the Baveno
VI consensus proposed the use of Transient Elastography
(TE) for exclusion of EV for a value under 20kPa. Our aim
was to assess the diagnostic value of serological scores (initially
developed for fibrosis evaluation) and transient elastrography(TE)
as screening tool for exclusion of EV. Methods:Our
study included 742 consecutive cirrhotic patients evaluated in
our Hemodynamic Labor undergoing upper GI endoscopy,
HVPG measurements, TE and serological tests between 2007
and 2014. Simple serological scores were calculated: Fibrosis
Index(FI), FIB-4, Forns score and Lok score. According to the
newly proposed TE quality criteria, ten valid measurements with
a median liver stiffness value≥7.1kPa and IQR/median>30%
were considered poorly reliable and not included into the
analysis. TE cases without 10 valid measurements were also
excluded. For TE was used the cut-off proposed by Baveno
VI consensus und for the other test the cut-offs with the best
negative predictive value. Results: The etiology of liver cirrhosis
was: viral-340 patients (45.8%), alcoholic-250 (33.7%),
others etiologies-152 (20.5%). The incidence of EV in different
etiologies of liver cirrhosis was: viral-153/340 patients (45%),
alcoholic-198/250 (79.2%), others-90/152 (59.2%). The proportion
of Child-Pugh A, B and C patients in each cohort of
patients was: viral etiology-60%, 30%, 10%; alcoholic etiology
-31.6%, 37.6%, 30.8% and others etiology -32.9%, 44.1%,
23%. For a cut-off value