A Clinical Prediction Rule and Platelet Count Predict Esophageal Varices in Children

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dc.contributor.authorCristobal Gana, Juan
dc.contributor.authorTurner, Dan
dc.contributor.authorMieli Vergani, Giorgina
dc.contributor.authorDavenport, Mark
dc.contributor.authorMiloh, Tamir
dc.contributor.authorAvitzur, Yaron
dc.contributor.authorYap, Jason
dc.contributor.authorMorinville, Veronique
dc.contributor.authorBrill, Herbert
dc.contributor.authorLing, Simon C.
dc.date.accessioned2024-01-10T13:10:49Z
dc.date.available2024-01-10T13:10:49Z
dc.date.issued2011
dc.description.abstractBACKGROUND & AIMS: The validation of noninvasive tests to diagnose esophageal varices is a priority in children because repeated endoscopic evaluations are too invasive. We measured the ability of a previously developed noninvasive clinical prediction rule (CPR) to predict the presence of esophageal varices in children. METHODS: We analyzed data from 108 children, younger than age 18, who received endoscopies at 8 centers, to assess portal hypertension from chronic liver disease or portal vein obstruction. Blood test and abdominal ultrasound scan results were obtained within 4 months of endoscopy. Grading of varices identified by endoscopy was confirmed by independent blinded review. Spleen size, based on data from the ultrasound scan, was expressed as a standard deviation score relative to normal values for age. RESULTS: Of the children studied, 74 had esophageal varices (69%), including 35 with large varices (32%). The best noninvasive predictors of esophageal varices of any size were as follows: platelet: spleen size z-score ratio (area under the receiver operating characteristic curve [AUROC], 0.84; 95% confidence interval [CI] 0.75-0.93), CPR (AUROC, 0.80; 95% CI, 0.70-0.91), and platelet count (AUROC, 0.79; 95% CI, 0.69-0.90). The positive predictive values for the CPR and platelet count were 0.87 and 0.86, the negative predictive values were 0.64 and 0.63, the positive likelihood ratios were 3.06 and 2.76, and the negative likelihood ratios were 0.64 and 0.63, respectively. Based on positive and negative predictive values, the most accurate noninvasive tests were the CPR and platelet counts. CONCLUSIONS: Noninvasive tests such as CPR and platelet count can assist in triaging children for endoscopy to identify esophageal varices.
dc.description.funderCanadian Association for Study of the Liver
dc.fechaingreso.objetodigital2024-04-25
dc.format.extent8 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1053/j.gastro.2011.08.049
dc.identifier.issn0016-5085
dc.identifier.pubmedidMEDLINE:21925123
dc.identifier.urihttps://doi.org/10.1053/j.gastro.2011.08.049
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/77942
dc.identifier.wosidWOS:000297329000022
dc.information.autorucMedicina;Gana J;S/I;8726
dc.issue.numero6
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final2016
dc.pagina.inicio2009
dc.publisherW B SAUNDERS CO-ELSEVIER INC
dc.revistaGASTROENTEROLOGY
dc.rightsacceso restringido
dc.subjectPortal Hypertension
dc.subjectPediatric Chronic Liver Disease
dc.subjectDiagnostic Tests
dc.subjectCOUNT/SPLEEN DIAMETER RATIO
dc.subjectCHRONIC LIVER-DISEASE
dc.subjectC VIRUS-INFECTION
dc.subjectBILIARY ATRESIA
dc.subjectNONINVASIVE DIAGNOSIS
dc.subjectPORTAL-HYPERTENSION
dc.subjectCIRRHOTIC-PATIENTS
dc.subjectPRIMARY PROPHYLAXIS
dc.subjectRANDOMIZED-TRIAL
dc.subjectVALIDATION
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleA Clinical Prediction Rule and Platelet Count Predict Esophageal Varices in Children
dc.typeartículo
dc.volumen141
sipa.codpersvinculados8726
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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