Novel Score for Prediction of Esophageal Varices in HCV- Related ‎Chronic Liver Disease Patients ‎

Abstract

Background and study aim: The most accurate procedure for detecting esophageal varices (EV) is esophagogastroduodenoscopy (EGD). It is, however, a time-consuming and intrusive treatment. As a result, a variety of noninvasive, easy, and inexpensive alternative screening methods for varices have been investigated. The PAPAS index (Platelet/Age/ Phosphatase/AFP/AST) was investigated for its utility in predicting the occurrence of EV in HCV-related cirrhotic patients. Patients and Method: A One hundred cirrhotic patients were studied in a cross-sectional study at Ain Shams University's Tropical Medicine Department. Upper gastrointestinal endoscopy was used to examine for the presence and severity of gastroesophageal varices in all individuals. The PAPAS Index, as well as other known predictive scores, were calculated. Results: Patients with EV had a higher PAPAS index with a significant value. The PAPAS index had a greater prediction ability than other existing scores for detecting EV and large EV (APRI, FIB-4, and Lok Score). With 86% sensitivity, 93.33% specificity, 95.2 % PPV, 73.7% NPV in detecting EVs and 94.87 % sensitivity, 86.43% specificity, 71.2% PPV, 86.7 % NPV in detecting Large EVs, the PAPAS index at cutoffs greater than 0.3 and 0.3056 was useful for diagnosing EVs and large EVs, respectively. Conclusion: The PAPAS index is a new score for predicting esophageal varices in HCV-related cirrhotic patients that could help enhance the quality of non-invasive EV and large EV screening and reduce the need for endoscopic procedures.