Abstract
Background: Esophageal vein rebleeding is a life-threatening complication of liver cirrhosis. However, the role of non-invasive methods that were developed to evaluate the severity of chronic liver disease, especially in rebleeding, remains unclear.Aims: To evaluate the performance of liver stiffness and non-invasive fibrosis scores in predicting esophageal vein rebleeding in hepatitis B virus (HBV) cirrhotic patients.Methods: A prospective analysis of 194 HBV patients between 2017 and 2021 was performed. Receiver operating characteristic (ROC) curves and time-dependent ROC curves were used to assess the power for predicting rebleeding with non-invasive fibrosis score and liver stiffness.Results: During the median follow-up time of 68.28 weeks, 55 patients experienced rebleeding. In the entire cohort, the area under the ROC curve for liver stiffness measurement (LSM) predicting for rebleeding was 0.837, with a cut-off value of 17.79 kPa, and the time-dependent ROC curve also showed stable prediction performance of LSM. The predictive ability of the non-invasive fibrosis score was less than that of LSM, and there were statistical differences. Moreover, patients using non-selective beta-blockers and HBV DNA-negative patients experienced significantly reduced rebleeding.Conclusions: Compared with non-invasive fibrosis scores, LSM can more simply and accurately predict rebleeding events of hepatitis B liver cirrhosis.
Highlights
Liver cirrhosis is caused by various injury mechanisms which can induce liver necrosis and fibrosis
Our study aims to evaluate non-invasive serological indices, namely, the AST to Platelet Ratio Index (APRI), Fibrosis-4 score (FIB-4), King’s College Criteria (King’s Score), Goteborg University Cirrhosis Index (GUCI), FibroIndex, and FornsIndex, and determine their accuracy in predicting bleeding events in hepatitis B liver cirrhosis patients
We compared the predictive performance of transient elastography. This was a prospective cohort study, and consecutive hospitalized patients with hepatitis B liver cirrhosis were admitted to the Department of Gastroenterology, the First Affiliated Hospital of Nanchang University in China, between February 2017 and January 2021
Summary
Liver cirrhosis is caused by various injury mechanisms which can induce liver necrosis and fibrosis. It is considered not a single disease entity but a disease that can be subdivided into different clinical prognostic stages [1]. Esophageal variceal bleeding (EVB) is a common complication of liver cirrhosis, and it can be a life-threatening complication due to high morbidity and high mortality [2]. Is the mortality rate of the first esophageal venous bleeding high, but the 6-week rebleed rate is up to 60% in patients who have not undergone secondary prevention patients [4]. Esophageal vein rebleeding is a life-threatening complication of liver cirrhosis. The role of non-invasive methods that were developed to evaluate the severity of chronic liver disease, especially in rebleeding, remains unclear
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