Which patients with cirrhosis should undergo endoscopic screening for esophageal varices (EV) detection

摘要: Our aims were to develop a noninvasive predictive tool identify cirrhotic patients with esophageal varices and evaluate whether portal Doppler ultrasonographic parameters may improve the value of other predictors. One hundred forty-three consecutive compensated underwent upper gastrointestinal endoscopy. Fourteen clinical, biochemical, ultrasonographic, each patient also recorded. Esophageal detected in 63 143 examined (44%; 95% confidence interval [CI] 36.2-52.6). Medium large observed 28 subjects CI 31.4-58.4). Using stepwise logistic regression, presence was independently predicted by prothrombin activity less than 70% (odds ratio [OR]: 5.83; CI: 2.6-12.8), vein diameter greater 13 mm (OR: 2.92; 1.3-6.4), platelet count 100 3 109/L 2.83; 1.27-6.28). Variables included model used generate simple incremental rule individual patient. The discriminating ability prediction relevant (area under curve: 0.80) did not change replacing congestion index vein. We concluded that should be screened endoscopy when 70%, 109/L, than13 are observed, whereas those without any these predictors undergo contribution provided does appear practical utility. (HEPATOLOGY 2001;33:333-338.)