A validated clinical tool for the prediction of varices in PBC: The Newcastle Varices in PBC Score

Imran Patanwala, Peter McMeekin, Ruth Walters, George Mells, Graeme Alexander, Julia Newton, Hemant Shah, Catalina Coltescu, Gideon Hirschfield, Mark Hudson, Dave Jones

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

Background & Aims - Gastro-oesophageal varices (GOV) can occur in early stage primary biliary cirrhosis (PBC), making it difficult to identify the appropriate time to begin screening with oesophageo-gastro-duodenoscopy (OGD). Our aim was to develop and validate a clinical tool to predict the probability of finding GOV in PBC patients. Methods - A cross-sectional retrospective study analysing clinical data of 330 PBC patients who underwent an OGD at the Freeman Hospital, Newcastle was used to create a predictive tool, the Newcastle Varices in PBC (NVP) Score, that was externally validated in PBC patients from Cambridge (UK) and Toronto (Canada). Results - 48% of the Newcastle, 31% of the Cambridge, and 22% of the Toronto cohorts of PBC patients had GOV. Twenty-five percent (95% CI 18–32%) of the Newcastle cohort had GOV diagnosed at an index variceal bleed. Of the others, 37% (95% CI 28–46%) bled after a median of 1.5 years (IQR 3.75). Transplant-free survival was significantly better in those without GOV than in those with GOV (p
Original languageEnglish
Pages (from-to)327-335
JournalJournal of Hepatology
Volume59
Issue number2
DOIs
Publication statusPublished - Aug 2013

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