Prevalence and Predictors of Esophageal Varices in Patients With Primary Biliary Cirrhosis

Cynthia Levy, Claudia O. Zein, Justin Gomez, Consuelo Soldevila-Pico, Roberto Firpi, Giuseppe Morelli, David Nelson

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)803-808
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume5
Issue number7
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

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Esophageal and Gastric Varices
Biliary Liver Cirrhosis
Platelet Count
Endoscopy
Odds Ratio
Confidence Intervals
Hemorrhage
ROC Curve
Multivariate Analysis
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Prevalence and Predictors of Esophageal Varices in Patients With Primary Biliary Cirrhosis. / Levy, Cynthia; Zein, Claudia O.; Gomez, Justin; Soldevila-Pico, Consuelo; Firpi, Roberto; Morelli, Giuseppe; Nelson, David.

In: Clinical Gastroenterology and Hepatology, Vol. 5, No. 7, 01.07.2007, p. 803-808.

Research output: Contribution to journalArticle

Levy, Cynthia ; Zein, Claudia O. ; Gomez, Justin ; Soldevila-Pico, Consuelo ; Firpi, Roberto ; Morelli, Giuseppe ; Nelson, David. / Prevalence and Predictors of Esophageal Varices in Patients With Primary Biliary Cirrhosis. In: Clinical Gastroenterology and Hepatology. 2007 ; Vol. 5, No. 7. pp. 803-808.
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