P-118 NONINVASIVE PARAMETERS OF PREDICTORS OF ESOPHAGEAL VARICES (EV) IN CHILDREN WITH INTRAHEPATIC PORTAL HYPERTENSION

Introduction

Children with portal hypertension (PH) are at risk for variceal bleeding. The standard test for screening varices is endoscopy, an invasive method.

Objective

Evaluate noninvasive parameters of predictors of esophageal varices (EV) in children with intrahepatic portal hypertension.

Method

This cross-sectional study included 168 children with no history of GI bleeding who underwent the first screening endoscopy for EV (mean age: 8.3+-4.7 years). Patients were classified into two groups: G1: Child-Pugh A and G2: Child-Pugh B and C. The noninvasive methods assessed were: 1) platelet count; 2) spleen size; 3) spleen size z score; 4) platelet count/spleen size ratio; 5) platelet count and spleen size z score ratio; 6) platelet count and equivalent adult spleen size ratio; 7) APRI; 8) CPR; 9) Risk score and 10) King's variceal prediction score. Continuous variables were expressed as the median and interquartile range (25%-75%) and compared using the Mann-Whitney test. The distribution of variables was analyzed through the chi-square test, with Fisher exact test, 2tailed. ROC curve analysis was used to calculate diagnostic accuracy as areas under the curve (AUROC); 95%confidence intervals (CI). The significance was considered when P<0.05.

Results

The incidence rate of EV was: G1 49.4% (44/89) and G2 64.6% (51/79) (OR 1.86-95% CI 1.001-3.47). The significant predictor of EV for G1was the Risk score: OR 0.813 (95% CI 0.723-0.903) and for G2, platelet count/spleen size z score: OR 0.849 (95% CI 0.756-0.943).

Conclusions

The noninvasive predictors of EV varied according to the severity of the disease. The Risk Score forecasted EV in children Child A. Platelets/spleen size predicted EV in children Child B and C.