{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:30:26Z","timestamp":1786739426234,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Only a small proportion of patients with compensated advanced chronic liver disease (cACLD) had varices needing treatment (VNT) after recommended esophagogastroduodenoscopy (EGD) screening. We aimed to create a non-invasive nomogram based on routine tests to detect VNT in cACLD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The training cohort included 162 cACLD patients undergoing EGD in a university hospital, between January 2014 and September 2019. A nomogram was developed based on the independent predictors of VNT, selected using a multivariate logistic regression analysis. Thirty-three patients from eight university hospitals were prospectively enrolled as validation cohort between December 2018 and December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The prevalence of VNT was 32.7% (53\/162) and 39.4% (13\/33) in training and validation cohorts, respectively. The univariate analysis identified six risk factors for VNT. On the multivariate analysis, four of them, i.e., gallbladder wall thickness (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 0.98-1.56), spleen diameter (OR: 1.02; 95% CI: 1.00-1.04), platelet count (OR: 0.98; 95% CI: 0.97-0.99), and international normalized ratio (OR: 0.58; 95% CI: 0.06-5.84) were independently associated with VNT. Thus, a nomogram based on the four above - mentioned variables was developed, and showed a favorable performance for detecting VNT, with an area under receiver operating characteristic curve of 0.848 (95% CI: 0.769-0.927) in training cohort. By applying a cut-off value of 105 in validation cohort, 31.0% of EGD were safely spared with 3.4% of missed VNT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A nomogram based on routine clinical parameters was developed for detecting VNT and avoiding unnecessary EGD in cACLD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjg.sjg_22_21","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T07:29:01Z","timestamp":1627543741000},"page":"376-382","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Development and validation of a nomogram for predicting varices needing treatment in compensated advanced chronic liver disease"],"prefix":"10.4103","volume":"27","author":[{"given":"Jitao","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxin","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinlong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanna","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingge","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengyun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunpeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengxiao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiling","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Dang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dengxiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-9-20240829","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1002\/hep.28824","article-title":"Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The \u201cAnticipate\u201d study","volume":"64","author":"Abraldes","year":"2016","journal-title":"Hepatology"},{"key":"R3-9-20240829","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1002\/hep.29363","article-title":"Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease","volume":"66","author":"Augustin","year":"2017","journal-title":"Hepatology"},{"key":"R4-9-20240829","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1053\/j.gastro.2012.10.001","article-title":"Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis","volume":"144","author":"Berzigotti","year":"2013","journal-title":"Gastroenterology"},{"key":"R5-9-20240829","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jhep.2008.08.018","article-title":"Early detection in routine clinical practice of cirrhosis and oesophageal varices in chronic hepatitis C: Comparison of transient elastography (FibroScan) with standard laboratory tests and non-invasive scores","volume":"50","author":"Castera","year":"2009","journal-title":"J Hepatol"},{"key":"R6-9-20240829","first-page":"1","article-title":"Surgery and portal hypertension","volume":"1","author":"Child","year":"1964","journal-title":"Major Probl Clin Surg"},{"key":"R7-9-20240829","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1053\/j.gastro.2012.05.035","article-title":"Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis","volume":"143","author":"Colecchia","year":"2012","journal-title":"Gastroenterology"},{"key":"R8-9-20240829","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.jhep.2018.04.023","article-title":"A combined model based on spleen stiffness measurement and Baveno VI criteria to rule out high-risk varices in advanced chronic liver disease","volume":"69","author":"Colecchia","year":"2018","journal-title":"J Hepatol"},{"key":"R9-9-20240829","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1002\/jcu.1870190606","article-title":"Thickening of the gallbladder wall in ascites","volume":"19","author":"Colli","year":"1991","journal-title":"J Clin Ultrasound"},{"key":"R10-9-20240829","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S2468-1253(18)30270-X","article-title":"Accelerating the elimination of viral hepatitis: A lancet gastroenterology & hepatology commission","volume":"4","author":"Cooke","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R11-9-20240829","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","article-title":"Expanding consensus in portal hypertension: Report of the Baveno VI consensus workshop: Stratifying risk and individualizing care for portal hypertension","volume":"63","author":"de Franchis","year":"2015","journal-title":"J Hepatol"},{"key":"R12-9-20240829","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1055\/s-0043-103952","article-title":"EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (long version)","volume":"38","author":"Dietrich","year":"2017","journal-title":"Ultraschall Med"},{"key":"R13-9-20240829","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1016\/j.cgh.2019.01.025","article-title":"Machine learning-based development and validation of a scoring system for screening high-risk esophageal varices","volume":"17","author":"Dong","year":"2019","journal-title":"Clin Gastroenterol Hepatol"},{"key":"R14-9-20240829","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1111\/liv.14310","article-title":"Validation of the AASLD recommendations for classification of oesophageal varices in clinical practice","volume":"40","author":"Fateen","year":"2020","journal-title":"Liver Int"},{"key":"R15-9-20240829","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1111\/liv.14373","article-title":"Baveno VI and expanded Baveno VI criteria successfully predicts the absence of high-risk gastro-oesophageal varices in a chilean cohort","volume":"40","author":"Gaete","year":"2020","journal-title":"Liver Int"},{"key":"R16-9-20240829","doi-asserted-by":"crossref","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":"R17-9-20240829","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1056\/NEJMra0901512","article-title":"Management of varices and variceal hemorrhage in cirrhosis","volume":"362","author":"Garcia-Tsao","year":"2010","journal-title":"N Engl J Med"},{"key":"R18-9-20240829","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1002\/hep.21907","article-title":"Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis","volume":"46","author":"Garcia-Tsao","year":"2007","journal-title":"Hepatology"},{"key":"R19-9-20240829","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/liv.13379","article-title":"Validating, deconstructing and refining Baveno criteria for ruling out high-risk varices in patients with compensated cirrhosis","volume":"37","author":"Jangouk","year":"2017","journal-title":"Liver Int"},{"key":"R20-9-20240829","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.jhep.2015.07.001","article-title":"Individualized care for portal hypertension: Not quite yet","volume":"63","author":"Kamath","year":"2015","journal-title":"J Hepatol"},{"key":"R21-9-20240829","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/jhep.2001.22172","article-title":"A model to predict survival in patients with end-stage liver disease","volume":"33","author":"Kamath","year":"2001","journal-title":"Hepatology"},{"key":"R22-9-20240829","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jhep.2006.04.006","article-title":"Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varices","volume":"45","author":"Kazemi","year":"2006","journal-title":"J Hepatol"},{"key":"R23-9-20240829","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1038\/ajg.2011.160","article-title":"Risk assessment of esophageal variceal bleeding in B-viral liver cirrhosis by a liver stiffness measurement-based model","volume":"106","author":"Kim","year":"2011","journal-title":"Am J Gastroenterol"},{"key":"R24-9-20240829","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1111\/jgh.13781","article-title":"Validation of noninvasive methods to predict the presence of gastroesophageal varices in a cohort of patients with compensated advanced chronic liver disease","volume":"32","author":"Llop","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"key":"R25-9-20240829","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/liv.13318","article-title":"Liver stiffness and platelet count for identifying patients with compensated liver disease at low risk of variceal bleeding","volume":"37","author":"Marot","year":"2017","journal-title":"Liver Int"},{"key":"R26-9-20240829","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.jhep.2016.06.021","article-title":"Validation of the Baveno VI criteria to identify low risk cirrhotic patients not requiring endoscopic surveillance for varices","volume":"65","author":"Maurice","year":"2016","journal-title":"J Hepatol"},{"key":"R27-9-20240829","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S0168-8278(02)00420-8","article-title":"Incidence and natural history of small esophageal varices in cirrhotic patients","volume":"38","author":"Merli","year":"2003","journal-title":"J Hepatol"},{"key":"R28-9-20240829","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1016\/j.jhep.2018.05.019","article-title":"Non-invasive prediction of esophageal varices by stiffness and platelet in non-alcoholic fatty liver disease cirrhosis","volume":"69","author":"Petta","year":"2018","journal-title":"J Hepatol"},{"key":"R29-9-20240829","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1080\/00365521.2019.1585571","article-title":"Evaluation of liver stiffness by 2D-SWE in combination with non-invasive parameters as predictors for esophageal varices in patients with advanced chronic liver disease","volume":"54","author":"Petzold","year":"2019","journal-title":"Scand J Gastroenterol"},{"key":"R30-9-20240829","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1148\/radiol.2018180425","article-title":"Virtual hepatic venous pressure gradient with CT angiography (CHESS 1601): A prospective multicenter study for the noninvasive diagnosis of portal hypertension","volume":"290","author":"Qi","year":"2019","journal-title":"Radiology"},{"key":"R31-9-20240829","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S2468-1253(18)30232-2","article-title":"Emerging non-invasive approaches for diagnosis and monitoring of portal hypertension","volume":"3","author":"Qi","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"R32-9-20240829","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1259\/0007-1285-63-756-922","article-title":"Gallbladder wall thickening (congestive cholecystopathy) in chronic liver disease: A sign of portal hypertension","volume":"63","author":"Saverymuttu","year":"1990","journal-title":"Br J Radiol"},{"key":"R33-9-20240829","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jhep.2010.04.019","article-title":"Prediction of oesophageal varices in hepatic cirrhosis by simple serum non-invasive markers: Results of a multicenter, large-scale study","volume":"53","author":"Sebastiani","year":"2010","journal-title":"J Hepatol"},{"key":"R34-9-20240829","doi-asserted-by":"crossref","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":"R35-9-20240829","doi-asserted-by":"crossref","first-page":"337","DOI":"10.2214\/ajr.136.2.337","article-title":"Sonography of the thickened gallbladder wall: A nonspecific finding","volume":"136","author":"Shlaer","year":"1981","journal-title":"AJR Am J Roentgenol"},{"key":"R36-9-20240829","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s12876-018-0852-5","article-title":"Gall bladder wall thickening as non-invasive screening parameter for esophageal varices - A comparative endoscopic - Sonographic study","volume":"18","author":"Tsaknakis","year":"2018","journal-title":"BMC Gastroenterol"},{"key":"R37-9-20240829","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/j.1440-1746.1997.tb00464.x","article-title":"Gall-bladder wall thickening in patients with liver cirrhosis","volume":"12","author":"Wang","year":"1997","journal-title":"J Gastroenterol Hepatol"},{"key":"R38-9-20240829","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1002\/jcu.1870150503","article-title":"Gallbladder wall thickening: A frequent finding in various nonbiliary disorders--A prospective ultrasonographic study","volume":"15","author":"Wegener","year":"1987","journal-title":"J Clin Ultrasound"}],"container-title":["Saudi Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sjg.sjg_22_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:28:52Z","timestamp":1786735732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sjg.sjg_22_21"}},"subtitle":["A multicenter study"],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/sjg.sjg_22_21","relation":{},"ISSN":["1319-3767"],"issn-type":[{"value":"1319-3767","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}