Baveno VII algorithm outperformed other models in ruling out high-risk varices in individuals with HBV-related cirrhosis

作者：Xiaofeng Zhang, Jiankang Song, Yuanjian Zhang, Biao Wen, Lin Dai, Ranran Xi, Qiaoping Wu, Yuan Li, Xiaoqin Luo, Xiaoqin Lan, Qinjun He, Wenfan Luo, Qintao Lai, Yali Ji, Ling Zhou, Tingting Qi, Miaoxia Liu, Fuyuan Zhou, Weiqun Wen, Hui Li, Zhihua Liu, Yongpeng Chen, Youfu Zhu, Junying Li, Jing Huang, Xiao Cheng, Minghan Tu, Jinlin Hou, Haiyu Wang, Jinjun Chen · 发表于：Journal of Hepatology · 年份：2022 · DOI：10.1016/j.jhep.2022.10.030 · 被引用次数：57 · 研究领域：Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment、Abdominal Trauma and Injuries

BACKGROUND & AIMS: The Baveno VII consensus recommends that spleen stiffness measurement (SSM) ≤40 kPa is safe for ruling out high-risk varices (HRVs) and avoiding endoscopic screening in patients who do not meet the Baveno VI criteria. This study aimed to validate the performance of the Baveno VII algorithm in individuals with HBV-related cirrhosis. METHODS: Consecutive individuals with HBV-related cirrhosis who underwent liver stiffness measurement (LSM) and SSM - using a 50 Hz shear wave frequency, spleen diameter measurement, and esophagogastroduodenoscopy (EGD) were prospectively enrolled from June 2020. A 100 Hz probe has been adopted for additional SSM assessment since July 2021. RESULTS: From June 2020 to January 2022, 996 patients were screened and 504 were enrolled for analysis. Among the 504 patients in whom SSM was assessed using a 50 Hz probe, the Baveno VII algorithm avoided more EGDs (56.7% vs. 39.1%, p <0.001) than Baveno VI criteria, with a comparable missed HRV rate (3.8% vs. 2.5%). Missed HRV rates were >5% for all other measures: 11.3% for LSM-longitudinal spleen diameter to platelet ratio score, 20.0% for platelet count/longitudinal spleen diameter ratio, and 8.8% for Rete Sicilia Selezione Terapia-hepatitis. SSM@100 Hz was assessed in 232 patients, and the Baveno VII algorithm with SSM@100 Hz spared more EGDs (75.4% vs. 59.5%, p <0.001) than that with SSM@50 Hz, both with a missed HRV rate of 3.0% (1/33). CONCLUSIONS: We validated the Baveno VII algorith...