Noninvasive Markers Predicting Variceal Size: The Role Of Lok Score

Aims Upper gastrointestinal endoscopy is the gold standard method to detect esophageal varices. However, in some cases endoscopy could not be performed or be postponed because of technical difficulties or patient-related factors, and thus diagnosis and treatment may be delayed. The aim of our study was to investigate the correlation between noninvasive scores and variceal size.

Methods We performed a retrospective analytical study over 5 years period (2012-2017) including patients with chronic liver disease undergoing endoscopy for oesophageal varices screening or hospitalized for variceal bleeding. Patients with hepatocellular carcinoma or under band ligation protocol and without varices were excluded. We calculated non-invasive scores: Meld, Meld-Na, Fib-4, APRI, PALBI, age-platelet index and Lok score for each patient at the moment of endoscopy.

Results During the study period, we enrolled 89 patients. The mean age was 55,9 ± 14,17 years and the sex raio (F/H) was of 1.02. Most of patients were cirrhotic and 10 % presented non-cirrhotic portal hypertension. Viral hepatitis were the main cause of cirrhosis: viral C in 34.5 % of cases and viral B 16.7 % of cases. Child-Pugh score A was prevalent (50.6 %). Among non-invasive markers calculated, only Lok score was associated to variceal size (p<0.0001). Patients with large esophageal varices were found to have significantly higher Lok score (mean 0.722 ± 0.229) versus patients with small esophageal varices (mean 0.900 ± 0.124). When analyzing the receiver operating characteristic (ROC) curve, LOK score had the better area under the curve (AUC) in predicting the size of varices (AUC = 0.731, p=0.001, 95 % CI: 0.593–0.870).

Conclusions We found a significant correlation between Lok score and the size of esophageal varices. According to our result, cirrhotic patients with varices who do not consent or tolerate endoscopic surveillance, LOK score can be a useful noninvasive method to evaluate variceal size.

Citation: Ayari M, Zaimi Y, Mensi A et al. OP197 NONINVASIVE MARKERS PREDICTING VARICEAL SIZE: THE ROLE OF LOK SCORE. Endoscopy 2021; 53: S81.

Publikationsverlauf

Artikel online veröffentlicht:
19. März 2021