Is P2/MS score valuable for prediction in HBV-related variceal bleeding?

Abstract

Objective: To determine the predictive value of P2/MS in patients with chronic HBV-related cirrhosis, and to predict high-risk esophageal varices, and obtain a cut-off value. Methods: A total of 412 patients with HBV-related cirrhosis who were admitted to our hospital between August 2014 and August 2017 were retrospectively evaluated. A diagnosis of cirrhosis was made with standard laboratory, radiological and physical examination findings. According to these evaluations, esophageal varices were classified as small, medium and large. For all obtained data, P2/MS was calculated. Two threshold values (P2/MS25) were considered in predicting the presence of high-risk EVs during recording. And the optimal cutoff value of the P2/MS index was determined for high-risk esophageal varices in patients with chronic viral hepatitis B. Results: A total of 375 patients who met the inclusion criteria were included in the study. When the P2/MS index was compared with other noninvasive tests, the mean and median P2/MS scores were respectively 54.17 and 33.25. The P2/MS value of the patients without esophageal varices was higher than that of the patients with esophageal varices. When these results were evaluated, the higher the score, the lower the risk of varices. We obtained a positive predictive value of 93.80% [95% CI (80.20-98.70)] when the cut-off value of P2/MS was taken as 25. Conclusions: We could predict the patients with high-risk esophageal varices within this group at a extremely good rate. We also compared the results of this test with other non-invasive tests and achieved successful results. We have shown that P2/MS can be used in order to optimally select patients for endoscopic screening and prevent all of the expensive and unnecessary procedures safely.

Keywords

• P2/MS score
• Chronic HBV-related cirrhosis
• Esophageal varices
• Predictive value