Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION. Digestive endoscopy is the study of choice for the diagnosis of varicose veins, it is an invasive procedure that sometimes may not be well tolerated by patients and has a high cost, which is why the FIB-4 index and Lok Score are proposed to predict varicose veins. esophagus in cirrhotic patients. AIM. To determine the usefulness of the FIB-4 and Lok Score markers as predictors of esophageal varices in
cirrhotic patients. MATERIALS AND METHODS. Diagnostic test evaluation study with 639 cirrhotic patients treated at the Carlos Andrade Marín Specialty Hospital between January 2010 and November 2021 who underwent upper digestive endoscopy for screening and measurement of Fibrosis-4 and Lok Score. The data was analyzed with SPSS V25. The qualitative variables were analyzed with frequencies and the quantitative
ones with dispersion measures, sensitivity, specificity, negative predictive value, positive predictive value and ROC curve were calculated. RESULTS. The mean age was 64,33 years, female predominance (50,2%), presence of esophageal varices in 80,4% of cases with complications in 2,4%, the most frequent being bleeding (2,2%). A significant association was evidenced between FIB-4 and Lok Score with the presence
of esophageal varices (p= 0,000). For the FIB-4 the sensitivity was 79,6%, specificity 43,2%, positive predictive value 85,2% and negative predictive value 33,9%. For the Lok Score sensitivity of 89,5%, specificity of 32,8%, positive predictive value 84,5% and negative predictive value 50%. CONCLUSION. FIB-4 and Lok Score are
useful as predictors of esophageal varices in patients with liver cirrhosis.
Peagu R, Sararu R, Necula A, Moldoveanu A, Petrisor A, Fierbinţeanu-Braticevici C. The role of spleen stiffness using ARFI in predicting esophageal varices in patients with Hepatitis B and C virus-related cirrhosis. 2019; 57(4): p. 334-340. Obtenido de DOI: 10.2478/rjim-2019-0017. Available from: https://pubmed.ncbi.nlm.nih.gov/31301679/
Jakab S, García-Tsao G. Screening and Surveillance of Varices in Patients With Cirrhosis. Clinical Gstroenterology and hepatology. 2018; 17(1): p. 26-29. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139072/
Tan Z, Sun H, Xue T, Gan C, Liu H, Ye T. Liver Fibrosis: Therapeutic Targets and Advances in Drug Therapy. Front Cell Dev Biol. 2021; 9. Available from:
https://pubmed.ncbi.nlm.nih.gov/34621747/
Caballería L, Torán P, Caballería J. Markers of hepatic fibrosis. Med Clin (Barc) 2018; 150(8): p. 310-316. Available from:
https://pubmed.ncbi.nlm.nih.gov/29055492/
Carrera M. Nivel de concordancia entre FIB4 y resultados de elastografía hepática realizadas entre enero de 2017 a diciembre de 2020 en el hospital de especialidades Carlos Andrade Marín. Tesis. Quito: Pontificia Universidad Católica del Ecuador; 2022. Disponible en:
http://repositorio.puce.edu.ec/handle/22000/20776
Cálamo-Guzmán B, De Vinatea-Serrano L, Piscoya A, Segura E. Desempeño del índice FIB-4 en el despistaje de várices esofágicas en pacientes con el diagnóstico de cirrosis hepática. Rev. gastroenterol. 2020; 40(1). Disponible en:
http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1022-51292020000100029
Lujan M, Díaz G, Martínez O, Morales A, Donado J, Marín J. Caracterización de pacientes con cirrosis hepática y bacteriemia de un hospital universitario en Medellín, Colombia. Rev Colomb Gastroenterol. 2020; 35(4): p. 455-464. Disponible en:
https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1156328
Muñoz R, Martínez P, Santillán W, Paullan V, Rodríguez G, Muñoz P. Complicaciones de la cirrosis hepática en pacientes hospitalizados en el Hospital Dr. Abel Gilbert Pontón. RevMICG. 2021; 2(3): p. 22-29. Obtenido de https://revistaclinicaguayaquil.org/index.php/revclinicaguaya/article/view/72
Ecuador. Instituto Nacional de Estadísticas y Censos. Estadisticas vitales: Registro Estadístico de defunciones generales de 2021. [Online].; 2021. Disponible en:
Ishida K, Namisaki T, Murat K, Fujimoto Y, Takeda S, Yoshiji H. Accuracy of Fibrosis-4 Index in Identification of Patients with Cirrhosis Who Could Potentially Avoid Variceal Screening Endoscopy. J. Clin. Med. 2020; 9(11): p. 3510. Available from:
https://pubmed.ncbi.nlm.nih.gov/33138335/
Hsieh YC, Lee KC, Wang YW, Yang YY, Hou MC, Lin HC. Correlation and prognostic accuracy between noninvasive liver fibrosismarkers and portal pressure in cirrhosis: Role of ALBI score. PLoS One. 2018; 13(12). Available from:
https://pubmed.ncbi.nlm.nih.gov/30540824/
Lesmana C, Pakasi L, Sudoyo A, Krisnuhoni E, Lesmana L. The Clinical Significance of Colon Polyp Pathology in Nonalcoholic Fatty Liver Disease (NAFLD) and Its Impact on Screening Colonoscopy in Daily Practice. Can J Gastroenterol Hepatol. 2020. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746467/
Roberts D, Best L, Freeman S, Sutton A, Cooper N, Gurusamy K. Treatment for bleeding oesophageal varices in people with decompensated liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev. 2021;(4). Available from:
https://pubmed.ncbi.nlm.nih.gov/33837526/
Pinto C, Parra P, Magna J, Gajardo A, Berger Z, Muñoz P. Hemorragia digestiva alta variceal y no variceal: mortalidad intrahospitalaria y características clínicas en un hospital universitario (2015-2017). Rev Med Chile. 2020; 148 (3): p. 288-294. Obtenido de
https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000300288
Alvarado-Tapias E. Estadio compensado y descompensado de la cirrosis: Implicaciones pronósticas y factores relacionados con la progresión de la enfermedad. Tesis doctoral. Barcelona: Universidad Autónoma de Barcelona, Departamento de Medicina; 2018. Disponible en:
https://www.tesisenred.net/handle/10803/664228#page=1
Bosch J, De Franchis R, Garcia G, Reiberger T, Ripoll C. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022; 76(4): 959-974. Available from:
https://pubmed.ncbi.nlm.nih.gov/35120736/
Salazar E. Etiología, reserva funcional hepática e índices de fibrosis en pacientes con diagnóstico de cirrosis hepática que asisten a la consulta externa de gastroenterología del Hospital Escuela Dr. Roberto Calderón Gutiérrez, en el período de septiembre 2020. Tesis. Managua: Universidad Nacional
Autónoma de Nicaragua-Managua, Departamento de medicina interna; 2021. Disponible en:
https://repositorio.unan.edu.ni/16419/
Robles-Rodríguez R, Gutiérrez R, Garduño I, Govea O. Predictores no invasivos de várices esofágicas y otros hallazgos endoscópicos de hipertensión portal en pacientes con hepatopatía crónica. Endoscopia. 2020. Vol. 32 ( Supl 2): Sept 2020. Obtenido de:
https://www.scielo.org.mx/scielo.php?pid=S2444-64832020000600208&script=sci_arttext
Zhang F, Liu T, Gao P, Fei S. Predictive Value of a Noninvasive Serological Hepatic Fibrosis Scoring System in Cirrhosis Combined with Oesophageal Varices. Can J Gastroenterol Hepatol. 2018; 14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6112226/
Liu H, Chen P, Jiang B, Li F, Han T. The value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis. Journal of Clinical Laboratory Analysis. 2021; 35(3). Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957998/
Zhou H, Long J, Hu H, Tian CY, Lin SD. Liver stiffness and serum markers for excluding high-risk varices in patients who do not meet Baveno VI criteria. World J Gastroenterol. 2019; 25(35): p. 5323-5333. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761236/
Ishiba H, Sumida Y, Tanaka S, Yoneda M, Hyogo H, Itoh Y. The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study. J Gastroenterol. 2018; 53(11): p. 1216-1224. Available from:
https://pubmed.ncbi.nlm.nih.gov/29744597/
Glisic T, Stojkovic M, Milovanovic T, Rankovic I, Stojanovic M, Popovic D. Diagnostic Value of Non-invasive Scoring Systems in the Prediction of Esophageal Varices in Patients with Liver Cirrhosis-Single Center Experience. Medicina (Kaunas). 2022; 58(2): p. 158. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880721/
Cifci S, Ekmen N. Evaluation of Non-invasive Fibrosis Markers in Predicting Esophageal Variceal Bleeding. Clin Endosc. 2021; 54(6): p. 857-863. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8652170/
Goverdhan H, Jagdishoprasad S, Rangrao N, Hiralal T, Rajendra A. Role of non-invasive markers in prediction of esophageal varices and variceal bleeding in patients of alcoholic liver cirrhosis from central India. Turk J Gastroenterol. 2019; 30(12): p. 1036-1043. Obtenido de
https://pubmed.ncbi.nlm.nih.gov/31854309/
Ebada H, Ebrahim A, Elbareedy A, Salaheldin M, Allam A, Fouad R. Novel Score for Prediction of Esophageal
Varices in HCV- Related Chronic Liver Disease Patients . Afro-Egyptian Journal of Infectious and Endemic Diseases. 2021; 11(4): p. 343-353. Available from:
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