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Validation of Baveno VI and Expanded-Baveno VI Criteria for predicting gastroesophageal varices in patients with alcoholic and non- alcoholic fatty liver disease

Ahead of print available from 04/02/2022
These articles are scheduled for publication in Vol. 85 (2) 2021

Author(s) M. Pizzamiglio 1 #, A. Weicker 1 #, C. de Terwangne 2, J. Henrion 3, O.S. Descamps 1, M. De Vos 3
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DOI10.51821/88.2.9553
Affiliations:
(1) Department of Internal Medecine, Centres Hospitaliers de Jolimont, Haine Saint-Paul, Belgium
(2) Department of Geriatric Medicine, Centres Hospitaliers de Jolimont, Haine Saint-Paul, Belgium
(3) Department of Hepato-gastroenterology, Centres Hospitaliers de Jolimont, Haine Saint-Paul, Belgium
(#) Contributed equally

Background and aims: Baveno VI and Expanded-Baveno VI Criteria were validated to rule out high-risk esophageal varices (HRV) and to prevent unneeded endoscopies in compensated advanced chronic liver disease (cACLD) mainly related to viral hepatitis. We aim to assess these criteria to rule out low- and highrisk varices in patients with cACLD secondary to alcoholic liver disease (ALD) and non- alcoholic fatty liver disease (NAFLD).

Methods: Data were collected retrospectively from 2016 to 2020. Inclusion criteria were: NAFLD and /or ALD related cACLD, a liver stiffness measurement (LSM) = 10 kPa and an esophagogastroduodenoscopy (EGD) within 12 months. Exclusion criteria were: use of non cardioselective ß-blockers, hepatic decompensation, previous variceal bleeding, portal thrombosis, liver cancer, or liver transplant.

Results: One hundred and ninety-four patients were included in this study. Eighty-one patients (42%) met Baveno VI criteria and 103 (53%) met Expanded-Baveno VI criteria. Baveno VI criteria yielded a high negative predictive value (NPV = 95%) for detecting HRV and varices of any size. Expanded-Baveno VI criteria yielded a high NPV = 95% only for detecting HRV: the miss rate for varices of any size was 8%. Expanded-Baveno VI criteria could avoid more endoscopies than the original Baveno VI criteria to rule out HRV (53% versus 42%).

Conclusion: In this study, both criteria showed high NPV to rule out HRV but only original Baveno VI criteria yielded a satisfactory high NPV to rule out varices of any size. Expanded-Baveno VI criteria could avoid more endoscopies to exclude HRV.

Keywords: esophageal varices, transient elastography, NAFLD, ALD, cACLD
The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.