The bedside ABP criteria in comparison to Baveno VI criteria for esophageal varices screening in chronic hepatitis C patients

Alsebaey, Ayman; Hussein Mohammed, Ali; Elsamman, Mahmoud Kamal

doi:10.21608/smj.2025.388360.1576

The bedside ABP criteria in comparison to Baveno VI criteria for esophageal varices screening in chronic hepatitis C patients

Document Type : Original Article

Authors

¹ 1Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt

² Internal Medicine Department, Faculty of Medicine ,Sohag University, Egypt

³ Internal Medicine Department, Faculty of Medicine, Sohag University Hospital

10.21608/smj.2025.388360.1576

Abstract

Objectives: Esophageal variceal (EVs) bleeding is common and preventable by screening endoscopy, which is diagnostic and therapeutic but invasive and costly. We aimed to compare albumin, bilirubin, platelet (ABP) criteria to Baveno VI criteria as noninvasive screening tools for EVs.

Methods: A total of 661 patients were retrospectively evaluated. ABP parameters were defined as bilirubin ≥22 µmol/L, albumin ≤4 mg/dL, and platelets ≤114 ×10⁹/L. The Baveno VI criteria for positive EVs included Fibroscan ≥20 kPa and platelets ≤150 ×10⁹/L.

Results: Median age was 45 years. EVs were detected in 30.7% of patients. The Baveno VI criteria were fulfilled in 93.6% of EVs cases. Patients with EVs had a higher frequency of bilirubin ≥22 µmol/L, albumin ≤4 mg/dL, and platelets ≤114 ×10⁹/L than those without EVs. About 78.8% of EVs patients met ≥2 ABP parameters, while 77.3% of non-EVs patients met <2. Both criteria showed significant AUROC (p=0.001), higher with Baveno VI (0.871 vs. 0.833). Fulfilling both Baveno VI criteria had 93.6% sensitivity and 77.07% specificity. Meeting ≥2 ABP parameters showed 78.82% sensitivity and 77.29% specificity. Fulfillment of all 3 ABP criteria had 57.75% sensitivity and 67.42% specificity for large varices.

Conclusion: The ABP criteria are a promising, simple, noninvasive bedside screening tool for EVs, especially when ≥2 parameters are met. Both Baveno VI and ABP criteria offer comparable, non-invasive alternatives for EVs screening.

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