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Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children

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Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. / Sutton, Harry; Fitzpatrick, Emer; Davenport, Mark; Burford, Charlotte; Alexander, Emma; Dhawan, Anil; Grammatikopoulos, Tassos.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 67, No. 4, 10.2018, p. 446-451.

Research output: Contribution to journalArticle

Harvard

Sutton, H, Fitzpatrick, E, Davenport, M, Burford, C, Alexander, E, Dhawan, A & Grammatikopoulos, T 2018, 'Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children', Journal of Pediatric Gastroenterology and Nutrition, vol. 67, no. 4, pp. 446-451. https://doi.org/10.1097/MPG.0000000000002069

APA

Sutton, H., Fitzpatrick, E., Davenport, M., Burford, C., Alexander, E., Dhawan, A., & Grammatikopoulos, T. (2018). Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. Journal of Pediatric Gastroenterology and Nutrition, 67(4), 446-451. https://doi.org/10.1097/MPG.0000000000002069

Vancouver

Sutton H, Fitzpatrick E, Davenport M, Burford C, Alexander E, Dhawan A et al. Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. Journal of Pediatric Gastroenterology and Nutrition. 2018 Oct;67(4):446-451. https://doi.org/10.1097/MPG.0000000000002069

Author

Sutton, Harry ; Fitzpatrick, Emer ; Davenport, Mark ; Burford, Charlotte ; Alexander, Emma ; Dhawan, Anil ; Grammatikopoulos, Tassos. / Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. In: Journal of Pediatric Gastroenterology and Nutrition. 2018 ; Vol. 67, No. 4. pp. 446-451.

Bibtex Download

@article{5b432142649743b59920627a83dc06d7,
title = "Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children",
abstract = "Objectives: Investigate the use of spleen stiffness measurements (SSMs), measured by transient elastography (TE), for the prediction of clinically significant varices (CSV) in children with portal hypertension. Methods: This observational cohort study included children selected for endoscopy, as per department protocol, between September 2015 and June 2016. Those included underwent single TE FibroScan for liver stiffness measurements and SSM. Clinical and laboratory data were collected and variceal prediction scores were calculated at time of elastography. Results: In total 67 children (32 boys) underwent TE. Fifty-two children (25 boys) had chronic liver disease (CLD), 15 (7 boys) portal vein thrombosis (PVT). In all children SSM was the best predictor of CSV+ve, with an optimal cut-off value of 38.0 kPa (area under the receiver operator curve [AUROC]=0.92, sensitivity= 89%, specificity=82%, P<0.01). In the CLD group SSM was also the best predictor, with an optimal cut-off value of 38.05 kPa (AUROC=0.90, sensitivity= 84%, specificity=87%, P< 0.01). In the PVT group only SSM was predictive of CSV+ve, with an optimal cutoff value of 16.8 kPa (AUROC=1.00, sensitivity=100%, specificity = 100%, P<0.001). For the prediction of GI bleeding (n=6), liver stiffness measurement performed the best, with an optimal cut-off value of 34.3 kPa (AUROC=0.84, sensitivity of 80%, specificity of 88%, P = 0.01). Conclusions: SSM was the greatest predictor of CSV+ve in the whole cohort, and individual CLD and PVT groups. SSM could be used as a noninvasive screening tool for children with portal hypertension to stratify the risk of having CSV.",
keywords = "Clinically significant varices, Portal hypertension, Spleen stiffness, Transient elastography",
author = "Harry Sutton and Emer Fitzpatrick and Mark Davenport and Charlotte Burford and Emma Alexander and Anil Dhawan and Tassos Grammatikopoulos",
year = "2018",
month = oct,
doi = "10.1097/MPG.0000000000002069",
language = "English",
volume = "67",
pages = "446--451",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children

AU - Sutton, Harry

AU - Fitzpatrick, Emer

AU - Davenport, Mark

AU - Burford, Charlotte

AU - Alexander, Emma

AU - Dhawan, Anil

AU - Grammatikopoulos, Tassos

PY - 2018/10

Y1 - 2018/10

N2 - Objectives: Investigate the use of spleen stiffness measurements (SSMs), measured by transient elastography (TE), for the prediction of clinically significant varices (CSV) in children with portal hypertension. Methods: This observational cohort study included children selected for endoscopy, as per department protocol, between September 2015 and June 2016. Those included underwent single TE FibroScan for liver stiffness measurements and SSM. Clinical and laboratory data were collected and variceal prediction scores were calculated at time of elastography. Results: In total 67 children (32 boys) underwent TE. Fifty-two children (25 boys) had chronic liver disease (CLD), 15 (7 boys) portal vein thrombosis (PVT). In all children SSM was the best predictor of CSV+ve, with an optimal cut-off value of 38.0 kPa (area under the receiver operator curve [AUROC]=0.92, sensitivity= 89%, specificity=82%, P<0.01). In the CLD group SSM was also the best predictor, with an optimal cut-off value of 38.05 kPa (AUROC=0.90, sensitivity= 84%, specificity=87%, P< 0.01). In the PVT group only SSM was predictive of CSV+ve, with an optimal cutoff value of 16.8 kPa (AUROC=1.00, sensitivity=100%, specificity = 100%, P<0.001). For the prediction of GI bleeding (n=6), liver stiffness measurement performed the best, with an optimal cut-off value of 34.3 kPa (AUROC=0.84, sensitivity of 80%, specificity of 88%, P = 0.01). Conclusions: SSM was the greatest predictor of CSV+ve in the whole cohort, and individual CLD and PVT groups. SSM could be used as a noninvasive screening tool for children with portal hypertension to stratify the risk of having CSV.

AB - Objectives: Investigate the use of spleen stiffness measurements (SSMs), measured by transient elastography (TE), for the prediction of clinically significant varices (CSV) in children with portal hypertension. Methods: This observational cohort study included children selected for endoscopy, as per department protocol, between September 2015 and June 2016. Those included underwent single TE FibroScan for liver stiffness measurements and SSM. Clinical and laboratory data were collected and variceal prediction scores were calculated at time of elastography. Results: In total 67 children (32 boys) underwent TE. Fifty-two children (25 boys) had chronic liver disease (CLD), 15 (7 boys) portal vein thrombosis (PVT). In all children SSM was the best predictor of CSV+ve, with an optimal cut-off value of 38.0 kPa (area under the receiver operator curve [AUROC]=0.92, sensitivity= 89%, specificity=82%, P<0.01). In the CLD group SSM was also the best predictor, with an optimal cut-off value of 38.05 kPa (AUROC=0.90, sensitivity= 84%, specificity=87%, P< 0.01). In the PVT group only SSM was predictive of CSV+ve, with an optimal cutoff value of 16.8 kPa (AUROC=1.00, sensitivity=100%, specificity = 100%, P<0.001). For the prediction of GI bleeding (n=6), liver stiffness measurement performed the best, with an optimal cut-off value of 34.3 kPa (AUROC=0.84, sensitivity of 80%, specificity of 88%, P = 0.01). Conclusions: SSM was the greatest predictor of CSV+ve in the whole cohort, and individual CLD and PVT groups. SSM could be used as a noninvasive screening tool for children with portal hypertension to stratify the risk of having CSV.

KW - Clinically significant varices

KW - Portal hypertension

KW - Spleen stiffness

KW - Transient elastography

UR - http://www.scopus.com/inward/record.url?scp=85064249754&partnerID=8YFLogxK

U2 - 10.1097/MPG.0000000000002069

DO - 10.1097/MPG.0000000000002069

M3 - Article

C2 - 30234702

VL - 67

SP - 446

EP - 451

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

IS - 4

ER -

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