Recently, we read with great interest the study by Ma JL et al. [1] who mainly assessed a new model for predicting gastroesophageal varices (GOV) and variceal hemorrhage (VH) in patients with chronic liver diseases (CLDs). The new algorithm developed in this study is novel and provides evidence for the prediction of GOV and VH in CLDs patients. The author's great efforts are praiseworthy, but the following issues need to be carefully considered.
First, it needs to be emphasized that MELD score and Child–Pugh score are important indicators for evaluating the severity of liver function in CLDs patients, which have been widely recognized worldwide [2,3]. In addition, the above two scores are also generally used in clinical practice. However, these two scores were not reported in this study. Therefore, we do not know the severity of liver function in CLDs patients included in this study. Considering that the above two scores are evaluated according to the results of routine examinations in clinical practice, it is necessary to describe the severity of patients included in this study.
Second, previous studies have indicated that obesity is closely related to the progression of chronic viral hepatitis [4]. Evidence from a cohort study in the UK suggested that approximately 17% of cirrhosis is caused by excessive weight gain [5]. In addition, the prognosis of patients with obesity related cirrhosis is worse than that of non-obese patients [6]. Accordingly, the progression of cirrhosis increases the risk of GOV or VH in CLDs patients. However, body weight or body mass index, two important indicators of nutritional status commonly used in clinical practice, was not reported in this study.
Third, it is generally accepted that portal hypertension is an important factor leading to GOV and VH in CLDs patients. Is hepatic venous pressure gradient (HVPG) different between GOV and No-GOV patients in this study [7,8]? Is HVPG associated with GOV in CLDs patients? Although this is a retrospective cohort study, and it may be difficult to report HVPG values, we believe that solving this issue will help clinicians better understand the conclusion of this study.
Declaration of funding interestsNone.
Conflict of interestThe authors have no conflict of interest to declare.
