Diagnostic value of liver stiffness measurement combined with risk Scores for esophagogastric variceal bleeding in patients with hepatitis B cirrhosis

Abstract

Abstract Liver stiffness measurement (LSM) by transient elastography is a noninvasive test, but its accuracy is easily affected by various factors. This study aimed to assess the predictive value of LSM combined with three bleeding risk scoring systems, namely pre-endoscopy Rockall score (PRS), Glasgow Blatchford score (GBS), and AIMS65 score, for esophagogastric varices bleeding (EGVB) occurrence in patients with hepatitis B cirrhosis during hospitalization. We retrospectively analyzed 210 patients with hepatitis B cirrhosis, who were categorized into a bleeding group (70 cases) and a non-bleeding group (140 cases) according to whether EGVB occurred during hospitalization. Significant differences were observed between the two groups in systolic blood pressure, platelet count, albumin, urea nitrogen, LSM, pre-endoscopic Rockall score (PRS), Glasgow-Blatchford score (GBS), and AIMS65 score (all P < 0.05). The correlation analysis showed that LSM had significant positive relationship with PRS, GBS and AIMS65 score. Logistic regression analysis revealed that LSM and GBS score were independent risk factors for the occurrence of EGVB during hospitalization. ROC curve analysis showed that the combined prediction model of LSM and GBS score had the best prediction performance for EGVB occurrence, with an ROC curve area of 0.811, which was significantly better than the three risk scoring systems (P < 0.05), but similar to the predicted value of LSM (P = 0.335). Therefore, the combined use of LSM and GBS score can significantly improve the predictive effect of EGVB occurrence in patients with hepatitis B cirrhosis during hospitalization, and has important clinical significance for patients' prognosis.