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- Title
Development and validation of a nomogram for predicting varices needing treatment in compensated advanced chronic liver disease: A multicenter study.
- Authors
Wang, Jitao; Wei, Wenxin; Duan, Zhihui; Li, Jinlong; Liu, Yanna; Liu, Chuan; Zhang, Liting; Zhang, Qingge; Zhou, Shengyun; Zhang, Kunpeng; Gao, Fengxiao; Wang, Xiaojuan; Liao, Yong; Xu, Dan; Huang, Yifei; Wang, Shuai; Hu, Weiling; Mao, Hua; Xu, Ming; Dang, Tong
- Abstract
Background: Only a small proportion of patients with compensated advanced chronic liver disease (cACLD) had varices needing treatment (VNT) after recommended esophagogastroduodenoscopy (EGD) screening. We aimed to create a non-invasive nomogram based on routine tests to detect VNT in cACLD patients. Methods: The training cohort included 162 cACLD patients undergoing EGD in a university hospital, between January 2014 and September 2019. A nomogram was developed based on the independent predictors of VNT, selected using a multivariate logistic regression analysis. Thirty-three patients from eight university hospitals were prospectively enrolled as validation cohort between December 2018 and December 2019. Results: The prevalence of VNT was 32.7% (53/162) and 39.4% (13/33) in training and validation cohorts, respectively. The univariate analysis identified six risk factors for VNT. On the multivariate analysis, four of them, i.e., gallbladder wall thickness (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 0.98-1.56), spleen diameter (OR: 1.02; 95% CI: 1.00-1.04), platelet count (OR: 0.98; 95% CI: 0.97-0.99), and international normalized ratio (OR: 0.58; 95% CI: 0.06-5.84) were independently associated with VNT. Thus, a nomogram based on the four above - mentioned variables was developed, and showed a favorable performance for detecting VNT, with an area under receiver operating characteristic curve of 0.848 (95% CI: 0.769-0.927) in training cohort. By applying a cut-off value of 105 in validation cohort, 31.0% of EGD were safely spared with 3.4% of missed VNT. Conclusion: A nomogram based on routine clinical parameters was developed for detecting VNT and avoiding unnecessary EGD in cACLD patients.
- Subjects
LIVER disease treatment; RESEARCH; STATISTICS; ACADEMIC medical centers; CONFIDENCE intervals; PREDICTIVE tests; RESEARCH methodology evaluation; LIVER; CHRONIC diseases; INDEPENDENT variables; MULTIVARIATE analysis; CROSS-sectional method; MEDICAL cooperation; MEDICAL screening; ESOPHAGEAL varices; HUMAN services programs; GALLBLADDER; PLATELET count; DESCRIPTIVE statistics; STATISTICAL models; PREDICTIVE validity; ENDOSCOPIC gastrointestinal surgery; ROUTINE diagnostic tests; LOGISTIC regression analysis; ODDS ratio; SPLEEN; INTERNATIONAL normalized ratio; RECEIVER operating characteristic curves; DATA analysis software; LONGITUDINAL method
- Publication
Saudi Journal of Gastroenterology, 2021, Vol 27, Issue 6, p376
- ISSN
1319-3767
- Publication type
Article
- DOI
10.4103/sjg.sjg_22_21