Document Detail


Prevalence and predictors of esophageal varices in patients with primary biliary cirrhosis.
MedLine Citation:
PMID:  17544879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Esophageal varices and bleeding are among the most feared complications of primary biliary cirrhosis (PBC). We aimed to determine the prevalence of esophageal varices in patients with PBC, to evaluate noninvasive markers of esophageal varices in this population, and to validate the results in an independent set of patients. METHODS: Data were collected on all patients with PBC seen for the first time at the University of Florida (study group) and at Case Western Reserve University hospitals (cross-validation group) during 7 consecutive years. Logistic regression analysis was used to identify independent predictors of esophageal varices. The best cut-off values were calculated based on receiver operating characteristic curves. The diagnostic accuracy of the independent predictors of esophageal varices identified in the study group were retested in the cross-validation group. RESULTS: Of 210 patients with PBC seen at the University of Florida, 113 had an endoscopy and 49.6% (56 of 113) were found to have esophageal varices. After excluding 22 patients with a history of variceal bleeding, data on 91 patients were analyzed. Thirty-four patients had esophageal varices (37%). Multivariate analysis revealed that a platelet count of less than 140,000 (odds ratio, 7.6; 95% confidence interval, 1.6-37) and a Mayo risk score of 4.5 or greater (odds ratio, 10.6; 95% confidence interval, 1.8-62) were independent predictors of esophageal varices. The diagnostic accuracy of these predictors was confirmed in an independent set of patients. CONCLUSIONS: Among patients with PBC, a platelet count of less than 140,000 and/or a Mayo risk score of 4.5 or greater appears to identify those patients more likely to benefit from a screening endoscopy.
Authors:
Cynthia Levy; Claudia O Zein; Justin Gomez; Consuelo Soldevila-Pico; Roberto Firpi; Giuseppe Morelli; David Nelson
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-06-04
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  5     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-13     Completed Date:  2007-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  803-8     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida, Gainesville, Florida 32608, USA. levyc@medicine.ufl.edu
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MeSH Terms
Descriptor/Qualifier:
Biopsy
Confidence Intervals
Diagnosis, Differential
Endoscopy, Gastrointestinal
Esophageal and Gastric Varices / diagnosis,  epidemiology*,  etiology
Female
Follow-Up Studies
Humans
Liver Cirrhosis, Biliary / complications*
Male
Middle Aged
Odds Ratio
Prevalence
Prognosis
Retrospective Studies
Risk Factors
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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