{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:59:58Z","timestamp":1792036798663,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Cluj-Napoca University of Medicine and Pharmacy","award":["27020\/15.11.2011"],"award-info":[{"award-number":["27020\/15.11.2011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Liver stiffness (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>), spleen stiffness (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>) and serum markers have been proposed to non\u2010invasively assess portal hypertension or oesophageal varices (<jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content>) in cirrhotic patients. We aimed to evaluate the performance of a stepwise algorithm that combines Lok score with <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> for diagnosing high\u2010risk <jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HREV<\/jats:styled-content>) and to compare it with other already\u2010validated non\u2010invasive methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a cross\u2010sectional study including 136 consecutive compensated cirrhotic patients with various aetiologies, divided into training (90) and validation (46) set. Endoscopy was performed within 6\u00a0months from inclusion for <jats:styled-content style=\"fixed-case\">EV<\/jats:styled-content> screening. Spleen diameter was assessed by ultrasonography. <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> were measured using Fibroscan. Lok score, platelet count\/spleen diameter ratio, <jats:styled-content style=\"fixed-case\">LSM<\/jats:styled-content>\u2010spleen diameter to platelet ratio score and oesophageal varices risk score (<jats:styled-content style=\"fixed-case\">EVRS<\/jats:styled-content>) were calculated and their diagnostic accuracy for <jats:styled-content style=\"fixed-case\">HREV<\/jats:styled-content> was assessed. The algorithm classified patients as having\/not\u2010having <jats:styled-content style=\"fixed-case\">HREV<\/jats:styled-content>. Its performance was tested and compared in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the training set, all variables could select patients with <jats:styled-content style=\"fixed-case\">HREV<\/jats:styled-content> with moderate accuracy, the best being <jats:styled-content style=\"fixed-case\">LSPS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">AUROC<\/jats:styled-content>\u00a0=\u00a00.818; 0.93 sensitivity; 0.63 specificity). <jats:styled-content style=\"fixed-case\">EVRS<\/jats:styled-content>, however, was the only independent predictor of <jats:styled-content style=\"fixed-case\">HREV<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.521; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.032). The algorithm correctly classified 69 (76.66%) patients in the training set (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) and 36 (78.26%) in the validation one. In the validation group, the algorithm performed slightly better than <jats:styled-content style=\"fixed-case\">LSPS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EVRS<\/jats:styled-content>, showing 100% sensitivity and negative predicted value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The stepwise algorithm combining Lok score, <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content> could be used to select patients at low risk of having <jats:styled-content style=\"fixed-case\">HREV<\/jats:styled-content> and who may benefit from more distanced endoscopic evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12687","type":"journal-article","created":{"date-parts":[[2014,9,17]],"date-time":"2014-09-17T05:15:37Z","timestamp":1410930937000},"page":"317-325","source":"Crossref","is-referenced-by-count":36,"title":["Non\u2010invasive <i>m\u00e9nage \u00e0 trois<\/i> for the prediction of high\u2010risk varices: stepwise algorithm using lok score, liver and spleen stiffness"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-5471","authenticated-orcid":false,"given":"Horia","family":"Stefanescu","sequence":"first","affiliation":[{"name":"Hepatology Unit Regional Institute of Gastroenterology and Hepatology Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Radu","sequence":"additional","affiliation":[{"name":"Hepatology Unit Regional Institute of Gastroenterology and Hepatology Cluj\u2010Napoca Romania"},{"name":"3<sup>rd<\/sup> Medical Clinic Iuliu Hatieganu University of Medicine and Pharmacy Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Procopet","sequence":"additional","affiliation":[{"name":"Hepatology Unit Regional Institute of Gastroenterology and Hepatology 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