Validation of the EVendo score for the prediction of varices in cirrhotic patients
Khalid Alswat1, Mohammed Alanazi1, Ahmed Bashmail1, Maram Alkhamash1, Saleh A Alqahtani2, Waleed Al-Hamoudi3, Ayman A Abdo1
1 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
2 Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA; Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
3 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University; Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (59), Riyadh 11461
Source of Support: None, Conflict of Interest: None
Background: Screening endoscopy for varices may be deferred when the calculated EVendo score is ≤3.90. This novel score has not been validated in an external cohort. This study aimed to assess the performance of the EVendo score and compare it with the Baveno VI criteria.
Methods: We identified and calculated this score in all cirrhotic patients who underwent screening endoscopy for the first time with laboratory tests and liver stiffness measurements within 6 months of the endoscopy date.
Results: In total, 103 patients were included. An EVendo score of ≤3.90 identified patients with no gastroesophageal varices (GEV) and varices needing treatment (VNT) with sensitivities of 82% and 83% and specificities of 57% and 34%, respectively. The negative predictive value for VNT was 94%. A comparison with the Baveno VI criteria in Child–Turcotte–Pugh-A patients showed spared endoscopy and missed VNT rates with EVendo score cutoffs of ≤3.9 and ≤4.5 and the Baveno VI criteria of 25%, 33%, and 16.6% and 1.7%, 1.7%, and 0%, respectively.
Conclusions: EVendo score is reliable in clinical practice for predicting GEV and VNT. The number of spared endoscopies was higher than that with the Baveno VI criteria; however, there were more missed VNT cases.