A new model combining the liver/spleen volume ratio and classification of varices predicts HVPG in hepatitis B patients with cirrhosis

Eur J Gastroenterol Hepatol. 2015 Mar;27(3):335-43. doi: 10.1097/MEG.0000000000000269.

Abstract

Background: Although the therapy of varices in liver cirrhosis has improved, the mortality during a variceal hemorrhage episode remains high. Patients with hepatic venous pressure gradient (HVPG) greater than 12 mmHg have been identified as being at a higher risk for the first hemorrhage episode.

Aims: The aim of this study was to find an accurate method to predict HVPG greater than 12 mmHg.

Methods: A total of 150 hepatitis B patients with liver cirrhosis were enrolled and analyzed retrospectively. The patients were randomly divided into the experiment group and the validation group. The experiment group was used to construct a model to predict HVPG greater than 12 mmHg. The validation group was used to verify the predictive equation.

Results: The predictive model combined with the liver/spleen volume ratio and classification of varices was constructed to predict HVPG greater than 12 mmHg. The area under the curve of this predictive equation was 0.919. The values of sensitivity, specificity, positive predictive value, and negative predictive value were 92.9, 87.0, 89.7, and 90.9%, respectively. The following equation was used to calculate the HVPG score: HVPG score = 13.651 - 6.187×ln (liver/spleen volume)+2.755×[classification of varices score (classification of varices : small, 1; large; 2].

Conclusion: The new model combining the liver/spleen volume ratio and classification of varices can accurately predict HVPG in hepatitis B patients with cirrhosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Esophageal and Gastric Varices / pathology
  • Esophageal and Gastric Varices / physiopathology*
  • Esophageal and Gastric Varices / virology
  • Female
  • Gastrointestinal Hemorrhage / pathology
  • Gastrointestinal Hemorrhage / physiopathology
  • Gastrointestinal Hemorrhage / virology
  • Hepatic Veins / physiopathology*
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / pathology
  • Hepatitis B, Chronic / physiopathology
  • Humans
  • Liver / pathology*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / physiopathology*
  • Liver Cirrhosis / virology
  • Male
  • Middle Aged
  • Models, Statistical
  • Predictive Value of Tests
  • Retrospective Studies
  • Spleen / pathology*
  • Venous Pressure / physiology