Validation of a multivariate model predicting presence and size of varices

James R. Burton, Suthat Liangpunsakul, Jodi Lapidus, Edoardo Giannini, Naga Chalasani, Atif Zaman

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

BACKGROUND: A model developed by our group identified low platelets and advanced Child-Pugh class (CPC) as being associated with large varices. GOALS: To validate a defined cut-off of platelets ≤80,000/μL in CPC-A for large varices and platelets ≤90,000/μL in CPC-B/C for any varices. STUDY: Validation cohorts consisted of patients with cirrhosis undergoing screening for varices from Oregon Health and Science University (n=152), Indiana University (n=252), and Genoa, Italy (n=101). Similar clinical and laboratory data were collected as for the original cohort. To assess the ability of these cut-offs to predict presence of large and any varices, sensitivity, specificity, positive and negative predictive values, likelihood ratios, and the c-statistic were measured. RESULTS: The validation cohorts were statistically different from the original cohort with regards to CPC and prevalence of large varices. Combining the original (n=301) and validation cohorts resulted in a negative predictive value of 92.1% for platelets ≤80,000/μL in CPC-A for large varices and positive predictive value of 80.1% for platelets ≤90,000/μL in CPC-B/C for any varices. Combining the 4 cohorts yielded a c-statistic of 0.67 (95% confidence interval: 063-0.72). No other factors such as splenomegaly and Model for End-Stage Liver Disease score were identified as significant. CONCLUSIONS: This study confirms the validity of a previous model identifying low platelets and advanced CPC class as predictors of large varices. Despite combining the cohorts, no other risk factors were identified.

Original languageEnglish (US)
Pages (from-to)609-615
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume41
Issue number6
DOIs
StatePublished - Jul 2007

Fingerprint

Varicose Veins
Blood Platelets
End Stage Liver Disease
Splenomegaly
Italy
Fibrosis
Confidence Intervals
Sensitivity and Specificity
Health

Keywords

  • Cirrhosis
  • Screening
  • Varices

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Validation of a multivariate model predicting presence and size of varices. / Burton, James R.; Liangpunsakul, Suthat; Lapidus, Jodi; Giannini, Edoardo; Chalasani, Naga; Zaman, Atif.

In: Journal of Clinical Gastroenterology, Vol. 41, No. 6, 07.2007, p. 609-615.

Research output: Contribution to journalArticle

Burton, James R. ; Liangpunsakul, Suthat ; Lapidus, Jodi ; Giannini, Edoardo ; Chalasani, Naga ; Zaman, Atif. / Validation of a multivariate model predicting presence and size of varices. In: Journal of Clinical Gastroenterology. 2007 ; Vol. 41, No. 6. pp. 609-615.
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