Baveno VI and Expanded Baveno VI criteria successfully predicts the absence of high‐risk gastro‐oesophageal varices in a Chilean cohort

• Published in: Liver international 2020-06, Vol.40 (6), p.1427-1434
• Main Authors: Gaete, María I., Díaz, Luis A., Arenas, Alex, González, Katherine, Cattaneo, Máximo, Fuster, Francisco, Henríquez, Romina, Soza, Alejandro, Arrese, Marco, Barrera, Francisco, Arab, Juan P., Benítez, Carlos
• Format: Article
• Language: English
• Subjects: Cirrhosis; Criteria; Endoscopy; Esophagus; Fatty liver; gastrointestinal haemorrhage; gastro‐oesophageal varices; Hemorrhage; Liver; Liver cirrhosis; Liver diseases; non‐invasive; Patients; Platelets; portal hypertension; Risk; Sensitivity; Stiffness; transient elastography
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/liv.14373

Background Baveno VI and expanded Baveno VI criteria have been recommended to circumvent the need for endoscopy screening in patients with a very low probability of varices needing treatment (VNT). Aim To validate these criteria in a Latin American population. Methods The ability of Baveno VI criteria (liver stiffness measurement (LSM) 150 × 103/μL) and expanded Baveno VI criteria (LSM 110 × 103/μL) to exclude the presence of VNT was tested in a prospectively recruited cohort of patients with Child‐Pugh A liver cirrhosis and with no previous variceal haemorrhage who attended the liver clinics of three major hospitals in Chile. Results Three hundred patients were included. The median (IQR) age was 61 [18‐86] years, median MELD was 8.0 (6‐17), median LSM was 17.2 (10.2‐77) kPa and median platelet count was 137 (23‐464) × 103/μL. The main aetiology was non‐alcoholic fatty liver disease (67.3%). VNT were present in 18% of patients. The Baveno VI criteria had a sensitivity of 98.1% and a specificity of 38.2%, potentially sparing 31.3% of upper endoscopies with a very low risk of missing VNT (1.1%). The expanded Baveno VI criteria had a sensitivity of 90.7% and a specificity of 61%, potentially sparing 51.3% of upper endoscopies with a risk of missing VNT of 3.6%. Both criteria were independently associated with the absence of VNT. Conclusion We validated the Baveno VI and expanded Baveno VI criteria in Chilean population, potentially sparing 31.3% and 51.3% of endoscopies, respectively, with a very low risk of missing VNT. Fondecyt 1191183.