Research Article Details

Article ID: A07395
PMID: 32515534
Source: Hepatol Res
Title: Validation of albumin, bilirubin, and platelet criteria for avoiding screening endoscopy in patients with advanced fibrosis.
Abstract: 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&#160;g/dL, bilirubin <22&#160;&#956;mol/L, and platelets >114&#8201;000/&#956;L. RESULTS: Background liver disease were hepatitis&#160;C/hepatitis&#160;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&#160;&#956;mol/L (HR 2.00, 95% CI 1.2-3.4), albumin >4.0&#160;g/dL (HR 2.56, 95% CI 1.7-3.8), and platelets >114&#8201;000/&#956;L (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&#160;C/hepatitis&#160;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.
DOI: 10.1111/hepr.13533