{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:03:48Z","timestamp":1790089428899,"version":"4.0.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Esophagogastroduodenoscopy (EGD) is the gold standard for detecting high-risk varices (HRV) in patients with liver cirrhosis, but is invasive and resource-intensive. The Albumin-Bilirubin-Platelet (ABP) model is non-invasive, but its performance requires validation in diverse populations. This study aimed to validate and refine the ABP criteria to predict HRV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 474 patients with compensated cirrhosis, categorized into training (\n                      <jats:italic>n<\/jats:italic>\n                      = 332) and validation (\n                      <jats:italic>n<\/jats:italic>\n                      = 142) cohorts. All patients underwent EGD and laboratory evaluation. We evaluated the performance of the original and modified ABP (mABP) criteria, derived from the training cohort, to identify patients in whom screening EGD could be safely avoided.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalences of HRV were 15.96% and 20.42% in the training and validation cohorts, respectively. In multivariate analysis of the training cohort, only platelet count was an independent predictor of HRV (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). The original ABP criteria spared 21.83% of EGDs in the validation cohort with a 0% missed HRV rate. In the training cohort, the mABP criteria spared 51.51% of EGDs with a 2.34% missed HRV rate. The mABP criteria spared 58.45% of EGDs in the validation cohort, and the missed HRV rate was 4.82%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The original ABP criteria provide a simple and safe strategy for identifying low-risk patients with compensated cirrhosis. The modified ABP criteria substantially improve endoscopy avoidance while maintaining acceptable safety, offering a pragmatic alternative in settings where access to advanced diagnostic tools is limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1865640","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T13:46:18Z","timestamp":1784814378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Simplified non-invasive model based on albumin, bilirubin, and platelet count for predicting high-risk varices in compensated cirrhosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhihui","family":"Duan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.jhep.2018.09.014","article-title":"Burden of liver diseases in the world.","volume":"70","author":"Asrani","year":"2019","journal-title":"J Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1002\/hep.28906","article-title":"Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases.","volume":"65","author":"Garcia-Tsao","year":"2017","journal-title":"Hepatology"},{"key":"B3","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1053\/jhep.2003.50385","article-title":"Upper digestive bleeding in cirrhosis. 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The REAL experience.","volume":"114","author":"Calvaruso","year":"2019","journal-title":"Am J Gastroenterol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1650","DOI":"10.14309\/ajg.0000000000000722","article-title":"Deciding among noninvasive tools for predicting varices needing treatment in chronic liver disease: an analysis of Asian cohort.","volume":"115","author":"Sharma","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"5783748","DOI":"10.1155\/2020\/5783748","article-title":"Validation of the combined model based on platelet count and albumin to rule out high-risk varices in liver cirrhosis.","volume":"2020","author":"Duan","year":"2020","journal-title":"Biomed Res Int"},{"key":"B13","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.cgh.2019.11.015","article-title":"Identifying patients with cirrhosis who might avoid screening endoscopy based on serum albumin and bilirubin and platelet counts.","volume":"19","author":"Kew","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1111\/hepr.13533","article-title":"Validation of albumin, bilirubin, and platelet criteria for avoiding screening endoscopy in patients with advanced fibrosis.","volume":"50","author":"Tamaki","year":"2020","journal-title":"Hepatol Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"101598","DOI":"10.1016\/j.clinre.2020.101598","article-title":"Novel albumin, bilirubin and platelet criteria for the exclusion of high-risk varices in compensated advanced chronic liver disease: a validation study.","volume":"45","author":"Wong","year":"2021","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1097\/MEG.0000000000002270","article-title":"Prediction of high-risk esophageal varices in patients with compensated cirrhosis using albumin-bilirubin-platelet score.","volume":"34","author":"Abd Elbaser","year":"2022","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1097\/MEG.0000000000003085","article-title":"Comparison of the efficacy of platelet-albumin-bilirubin score vs. Child-Turcotte-Pugh, Model for End-Stage Liver Disease-Sodium, and complete Rockall score in predicting rebleed and mortality in patients presenting with variceal bleed.","volume":"38","author":"Sreenivas","year":"2026","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1007\/s00535-024-02109-8","article-title":"ALBI score predicts morphological changes in esophageal varices following direct-acting antiviral-induced sustained virological response in patients with liver cirrhosis.","volume":"59","author":"Atsukawa","year":"2024","journal-title":"J Gastroenterol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1111\/liv.15161","article-title":"Early prediction of decompensation (EPOD) score: non-invasive determination of cirrhosis decompensation risk.","volume":"42","author":"Schneider","year":"2022","journal-title":"Liver Int"}],"updated-by":[{"DOI":"10.3389\/fmed.2026.1951053","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000}}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1865640\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:22:21Z","timestamp":1790086941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1865640\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":19,"alternative-id":["10.3389\/fmed.2026.1865640"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1865640","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"article-number":"1865640"}}