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      External validation of Liaoning score for predicting esophageal varices in liver cirrhosis: a Chinese multicenter cross-sectional study

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          Abstract

          Background

          Our previous study developed Liaoning score as a non-invasive approach for predicting esophageal varices (EVs) in liver cirrhosis. This nationwide multicenter cross-sectional study aimed to externally validate the diagnostic accuracy of Liaoning score and further evaluate its performance for predicting high-risk EVs.

          Methods

          Cirrhotic patients with acute gastrointestinal bleeding (GIB) without history of endoscopic variceal therapy who underwent endoscopic examinations at their admissions were included. Liaoning score and several non-invasive liver fibrosis scores, including aspartate aminotransferase (AST) to platelet ratio index (APRI), AST to alanine aminotransferase ratio (AAR), fibrosis 4 index (FIB-4), King, and Lok scores, were evaluated. Area under curves (AUCs), cut-off value, sensitivity, and specificity were calculated.

          Results

          Overall, 612 patients were included. The prevalence of EVs and high-risk EVs was 96.2% and 95.6%, respectively. In overall patients, the AUCs of Liaoning score for predicting EVs and high-risk EVs were higher than non-invasive liver fibrosis scores (0.737 versus 0.626–0.721; 0.734 versus 0.611–0.719). The cut-off value of Liaoning score for high-risk EVs was 0.477 with a sensitivity of 81.96% and a specificity of 65.22%. In patients with hematemesis, Liaoning score could significantly predict EVs and high-risk EVs (AUCs =0.708 and 0.702, respectively), but not non-invasive liver fibrosis scores. The cut-off value of Liaoning score for high-risk EVs was 0.437 with a sensitivity of 83.16% and a specificity of 60%.

          Conclusions

          Liaoning score should be a non-invasive alternative for predicting EVs and high-risk EVs in cirrhotic patients with acute GIB.

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          Author and article information

          Journal
          Ann Transl Med
          Ann Transl Med
          ATM
          Annals of Translational Medicine
          AME Publishing Company
          2305-5839
          2305-5847
          December 2019
          December 2019
          : 7
          : 23
          : 755
          Affiliations
          [1 ]Department of Gastroenterology, General Hospital of Northern Theater Command , Shenyang 110840, China;
          [2 ]Department of Critical Care Medicine, The Sixth People’s Hospital of Shenyang , Shenyang 110006, China;
          [3 ]Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University , Jinan 250021, China;
          [4 ]Department for Biological Therapy, The Fifth Medical Center of PLA General Hospital , Beijing 100039, China;
          [5 ]Liver Research Center, The First Affiliated Hospital of Fujian Medical University , Fuzhou 350005, China;
          [6 ]Department of Hepatobiliary Disease, 900 Hospital of the Joint Logistics Team (formerly called Fuzhou General Hospital) , Fuzhou 350025, China;
          [7 ]Department of Gastroenterology, The First Affiliated Hospital of Nanchang University , Nanchang 330006, China;
          [8 ]Department of Gastroenterology, General Hospital of Western Theater Command , Chengdu 610083, China;
          [9 ]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University , Hangzhou 310003, China;
          [10 ]Department of Gastroenterology, The First Affiliated Hospital of China Medical University , Shenyang 110001, China;
          [11 ]Department of Gastroenterology, Xi’an Central Hospital , Xi’an 710003, China;
          [12 ]Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University , Beijing 100069, China
          Author notes

          Contributions: (I) Conception and design: X Qi; (II) Administrative support: X Qi; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: Y Wu, Q Zhu, F Meng, S Lin, B Liu, B Li, S Tang, Y Yang, Y Li, S Yuan, Y Chen; (V) Data analysis and interpretation: Y Wu, Q Zhu, F Meng, S Lin, B Liu, B Li, S Tang, Y Yang, Y Li, S Yuan, Y Chen; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

          [#]

          These authors contributed equally to this work.

          Correspondence to: Dr. Xingshun Qi, MD. Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang, 110840 Liaoning Province, China. Email: xingshunqi@ 123456126.com .
          Article
          PMC6990029 PMC6990029 6990029 atm-07-23-755
          10.21037/atm.2019.11.78
          6990029
          32042771
          d9f62f35-b416-4f97-89d2-0ed6d726dff3
          2019 Annals of Translational Medicine. All rights reserved.
          History
          : 12 September 2019
          : 05 November 2019
          Categories
          Original Article

          Liaoning score,Accuracy,diagnosis,endoscopy,esophageal varices (EVs)

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