Premium
Validation of albumin, bilirubin, and platelet criteria for avoiding screening endoscopy in patients with advanced fibrosis
Author(s) -
Tamaki Nobuharu,
Kurosaki Masayuki,
Higuchi Mayu,
Kirino Sakura,
Inada Kento,
Yamashita Koji,
Sekiguchi Shuhei,
Hayakawa Yuka,
Osawa Leona,
Takaura Kenta,
Maeyashiki Chiaki,
Kaneko Shun,
Yasui Yutaka,
Tsuchiya Kaoru,
Nakanishi Hiroyuki,
Itakura Jun,
Izumi Namiki
Publication year - 2020
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13533
Subject(s) - medicine , gastroenterology , bilirubin , albumin , etiology , varices , fatty liver , retrospective cohort study , endoscopy , liver disease , platelet , hepatitis b , disease , cirrhosis
Aim The albumin, bilirubin, and platelet (ABP) criteria was proposed to avoid screening endoscopy for detecting high‐risk varices (HRV) and it has high diagnostic accuracy. We carried out a retrospective cross‐sectional study to verify the diagnostic accuracy. Methods A total of 610 patients with advanced fibrosis were enrolled in the study. ABP criteria are defined as follows: albumin >4.0 g/dL, bilirubin <22 μmol/L, and platelets >114 000/μL. Results Background liver disease were hepatitis C/hepatitis B/non‐alcoholic fatty liver disease/others:405 (66.4%)/67 (10.5%)/78 (12.8%)/60 (10.3%). A total of 105 patients (17.2%) had HRV. In multivariate analysis, serum bilirubin <22 μmol/L (HR 2.00, 95% CI 1.2–3.4), albumin >4.0 g/dL (HR 2.56, 95% CI 1.7–3.8), and platelets >114 000/μL (HR 3.52, 95% CI 2.1–5.8) levels were independently associated with no presence of HRV. When the ABP criteria were examined, 200 patients (32.8%) fulfilled the criteria, and 194 patients had no HRV (positive predictive value 97.0%) When classified by etiologies (hepatitis C/hepatitis B/non‐alcoholic fatty liver disease), positive predictive value were 97.7/100/92.0%, respectively. Conclusions The ABP criteria are easy to examine, because they use only standard laboratory tests, and they are available for screening patients who might avoid endoscopy regardless of etiologies.