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Clinical scores for the prediction of esophageal varices in patients with liver cirrhosis.

INTRODUCTION: Esophageal bleeding is one of the most important and dramatic complications of liver cirrhosis in our everyday practice. Considering the costs of repeated upper endoscopy (UE) there is an increasing number of studies focusing on noninvasive para-meters for the assessment of esophageal varices (EV).

PATIENTS AND METHODS: Retrospective study included 74 patients with alcoholic and viral liver cirrhosis treated at Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia. The data were obtained from patients medical records including history, biochemical, ultrasonography and UE findings.

RESULTS: The average value of the RLLD/INR for patients who showed evidence of EV during UE and in those who didn't was 10.46 ± 3.09 and 12.24 ± 3.43, respectively (p = 0.019, p < 0.05). Cutoff value (11.5) of RLLD/INR showed a sensitivity of 64.15% and specificity of 66.67% (1.92LR+, and 0.54 LR-, AUROC 0.639) for the detection of EV. The average value of PC/SBD for patients who showed evidence of EV during UE and in those who didn't was 619.79 ± 492.96 and 1423.1 ± 908.2, respectively (p = 0.0, p < 0.05). The average value of RLLD/SA was 5.5 ± 0.17 and 4.57 ± 0.17 (p = 0.015, p < 0.05) for patients who showed evidence of EV -during UE and in those who didn't, respectively.

CONCLUSION: Noninvasive assessment of EV using scores based on ultrasonography and laboratory is simple, inexpensive, and could be a useful tool in limiting the number of repeated UE.

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