Diagnostic Accuracy of Non-invasive Laboratory-Based Fibrosis Scores in Predicting the Presence of Esophageal Varices in Liver Cirrhosis

Abstract

Cirrhosis is the end-stage for chronic liver disease and is the leading cause of liver-related death globally.1 Cirrhosis is frequently compensated. The development of complications of portal hypertension and/or liver dysfunction is decompensated cirrhosis. It is defined by the presence of variceal hemorrhage, ascites, encephalopathy, hepatorenal syndrome, jaundice or hepatocellular carcinoma. The transition from a compensated to a decompensated stage occurs at a rate of 5 to 7% per year.2 Esophageal variceal bleeding is a life-threatening portal hypertension-related complication in liver cirrhosis.3 Esophageal varices are present at diagnosis in approximately 50% of cirrhotic patients and the rate of development of new varices and increase in grades of varices is 8% per year.4 The mortality is 3.4% per year in patients with non-bleeding varices. By comparison, the mortality rises to 57% per year in patients with variceal bleeding. Thus, early diagnosis of varices and primary prophylaxis of variceal bleeding in high-risk patients with liver cirrhosis is important in improving survival.5