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 g/dL, bilirubin <22 μmol/L, and platelets >114 000/μL.

RESULTS:

Background liver disease were hepatitis C/hepatitis 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 μmol/L (HR 2.00, 95% CI 1.2-3.4), albumin >4.0 g/dL (HR 2.56, 95% CI 1.7-3.8), and platelets >114 000/μL (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 C/hepatitis 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.

• Authors: Nobuharu Tamaki, Masayuki Kurosaki, Mayu Higuchi, Sakura Kirino, Kento Inada, Koji Yamashita, Shuhei Sekiguchi, Yuka Hayakawa, Leona Osawa, Kenta Takaura, Chiaki Maeyashiki, Shun Kaneko, Yutaka Yasui, Kaoru Tsuchiya, Hiroyuki Nakanishi, Jun Itakura, Namiki Izumi
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 50 Issue 8 Pg. 996-999 (Aug 2020) ISSN: 1386-6346 [Print] Netherlands
• PMID: 32515534 (Publication Type: Journal Article)
• Copyright: © 2020 The Japan Society of Hepatology.