King's Variceal Prediction Score

Witters, Peter; Hughes, D.; Karthikeyan, P.; Ramakrishna, Somashekara Hosaagrahara; Davenport, Mark; Dhawan, Anil; Grammatikopoulos, Tassos

doi:10.1097/mpg.0000000000001423

Cited by 27 publications

(18 citation statements)

References 32 publications

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“…Our data support this finding, confirming that esophageal varices appear earlier and bleed more often among patients whose post-PE bilirubin remains elevated. In most previous studies addressing varices and variceal bleeding in BA [5,17,19,20], all patients were analyzed as one group although their pretest probability of liver disease complications differs markedly. The fact that the postoperative course of the liver disease depends essentially on PE success should be considered in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…The following previously published scores were calculated for successful primary treatment patients before each screening and scheduled control endoscopy: AST to Platelet Ratio Index (APRI): [(observed AST/ AST upper limit of normal)/platelet count]*100 [15]; spleen size Z score (SAZ): (observed spleen length − expected spleen length)/SD of the age and gender-based spleen length [16]; Varices Prediction Rule (VPR): albumin*platelet count/1000 [17]; Clinical Prediction Rule (CPR): (0.75*platelet count)/(SAZ + 5) + 2.5*albumin [18]; and King's Variceal Prediction Rule (K-VaPS): 3*albumin − 2*equivalent adult spleen size [5].…”

Section: Data Collectionmentioning

confidence: 99%

“…findings has been the goal of some previous studies [5][6][7][8] but these studies have pooled BA patients with successful and failed PE.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Poor performance of noninvasive predictors of esophageal varices during primary prophylaxis surveillance in biliary atresia

Lampela

Hukkinen

Kosola

et al. 2020

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

See 1 more Smart Citation

Poor performance of noninvasive predictors of esophageal varices during primary prophylaxis surveillance in biliary atresia

Lampela

Hukkinen

Kosola

et al. 2020

Journal of Pediatric Surgery

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“…1,4,6 Salah satu upaya untuk menyeragamkan nilai normal tersebut antara lain dengan pengembangan rumus estimasi panjang limpa dewasa atau dengan z score. 10 Kedua, penyebab penyakit hati kronik atau hipertensi portal pada anak sangat bervariasi, mulai dari penyakit kongenital hingga penyakit infeksi, sedangkan penyebab penyakit hati kronik pada dewasa relatif seragam akibat infeksi (virus hepatitis) atau alkohol. Ketiga, anak termasuk dalam subyek populasi rentan (vulnerable subjects) sehingga jumlah studi klinis pada anak lebih sedikit daripada dewasa.…”

Section: Pembahasanunclassified

“…11 Nilai z score dan SD yang diperoleh selanjutnya dapat diekstrapolasikan menjadi estimasi ukuran limpa pada dewasa dengan rumus tertentu (Lampiran 1). 10 Dalam studi diagnostik, sensitivitas dan spesifisitas berperan penting dalam menentukan kesahihan suatu alat uji baru dibandingkan baku emas dan tidak bergantung pada prevalens atau angka kejadian penyakit. Spesifisitas yang tinggi berperan untuk menegakkan suatu diagnosis jika hasil positif (rule in), sedangkan sensitivitas yang tinggi bermanfaat untuk menyingkirkan suatu penyakit jika hasil negatif (rule out).…”

Section: Pembahasanunclassified

Peran Metode Noninvasif dalam Mendeteksi Varises Esofagus Signifikan pada Anak dengan Hipertensi Portal

Iskandar¹,

Oswari

2020

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Latar belakang. Esofagogastroduodenoskopi (EGD) penting dilakukan pada anak dengan hipertensi portal untuk mendeteksi varises esofagus signifikan (derajat II, III, atau stigmata perdarahan), tetapi prosedur ini invasif dan traumatik.Tujuan. Mengetahui kemampuan metode noninvasif dibandingkan EGD dalam menentukan varises esofagus signifikan pada anak dengan hipertensi portal.Metode. Penelusuran literatur melalui Pubmed, Scopus, dan Cochrane Library dilakukan pada tanggal 25 Juni 2019. Kriteria inklusi adalah subyek anak hingga berusia 18 tahun, dipublikasi dalam 5 tahun terakhir, berbahasa Inggris, dan tersedia full text. Kriteria eksklusi adalah subyek pascaoperasi atau tidak membahas metode noninvasif. Artikel terpilih kemudian dinilai secara kritis.Hasil. Tiga buah artikel penelitian ditemukan, terdiri atas sebuah telaah sistematik dan dua buah penelitian observasional. Metode noninvasif yang memiliki sensitivitas tinggi adalah clinical prediction rule (80%), varices prediction rule (80%), dan risk score (85,7%). Metode yang memiliki spesifisitas tinggi adalah King’s variceal prediction score (72,7%).Kesimpulan. Metode noninvasif dapat digunakan untuk memilih prioritas pasien anak dengan hipertensi portal yang perlu dilakukan EGD untuk menentukan varises esofagus signifikan.

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Risk of variceal hemorrhage and pretransplant mortality in children with biliary atresia

Bass

Hawthorne

et al. 2022

Hepatology

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Background and Aims The natural history of gastroesophageal variceal hemorrhage (VH) in biliary atresia (BA) is not well characterized. We analyzed risk factors, incidence, and outcomes of VH in a longitudinal multicenter study. Approach and Results Participants enrolled in either an incident (Prospective Database of Infants with Cholestasis [PROBE]) or prevalent (Biliary Atresia Study of Infants and Children [BASIC]) cohort of BA were included. Variceal hemorrhage (VH) was defined based on gastrointestinal bleeding in the presence of varices accompanied by endoscopic or nontransplant surgical intervention. Cumulative incidence of VH and transplant‐free survival was compared based on features of portal hypertension (e.g., splenomegaly, thrombocytopenia) and clinical parameters at baseline in each cohort (PROBE: 1.5 to 4.5 months after hepatoportoenterostomy [HPE]; BASIC: at enrollment > 3 years of age). Analyses were conducted on 869 children with BA enrolled between June 2004 and December 2020 (521 in PROBE [262 (51%) with a functioning HPE] and 348 in BASIC). The overall incidence of first observed VH at 5 years was 9.4% (95% CI: 7.0–12.4) in PROBE and 8.0% (5.2–11.5) in BASIC. Features of portal hypertension, platelet count, total bilirubin, aspartate aminotransferase (AST), albumin, and AST‐to‐platelet ratio index at baseline were associated with an increased risk of subsequent VH in both cohorts. Transplant‐free survival at 5 years was 45.1% (40.5–49.6) in PROBE and 79.2% (74.1–83.4) in BASIC. Two (2.5%) of 80 participants who had VH died, whereas 10 (12.5%) underwent transplant within 6 weeks of VH. Conclusions The low risk of VH and associated mortality in children with BA needs to be considered in decisions related to screening for varices and primary prophylaxis of VH.

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King's Variceal Prediction Score

Abstract: Our new prediction score may be a useful tool in the selection of children with clinically significant varices eligible for a screening endoscopy.

Cited by 27 publications

References 32 publications

Poor performance of noninvasive predictors of esophageal varices during primary prophylaxis surveillance in biliary atresia

Poor performance of noninvasive predictors of esophageal varices during primary prophylaxis surveillance in biliary atresia

Peran Metode Noninvasif dalam Mendeteksi Varises Esofagus Signifikan pada Anak dengan Hipertensi Portal

Risk of variceal hemorrhage and pretransplant mortality in children with biliary atresia

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