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Validation of the New Diagnostic Criteria for Clinically Significant Portal Hypertension by Platelets and Elastography
Journal article   Peer reviewed

Validation of the New Diagnostic Criteria for Clinically Significant Portal Hypertension by Platelets and Elastography

Kristian Podrug, Vladimir Trkulja, Marko Zelenika, Tomislav Bokun, Anita Madir, Tajana Filipec Kanizaj, James O’Beirne and Ivica Grgurevic
Digestive Diseases and Sciences, Vol.67(7), pp.1-6
2022
PMCID: PMC8569849
PMID: 34739624
url
https://doi.org/10.1007/s10620-021-07277-8View
Published Version

Abstract

chronic liver disease liver cirrhosis portal hypertension elastography
Background and Aims: We aimed to validate newly proposed noninvasive criteria for diagnosing clinically significant portal hypertension (CSPH) using liver stiffness measurements (LSM) by transient elastography (TE) and platelet count. Methods: Diagnostic performance of these new criteria for CSPH (LSM ≥ 25 kPa to rule in and Plt ≥ 150 × 109/L + LSM ≤ 15 kPa to rule out CSPH) were retrospectively tested in an independent cohort of consecutive patients who underwent hepatic venous pressure gradient (HVPG) measurements and liver biopsy due to suspicion of compensated advanced chronic liver disease. Suspicion of cACLD was based on LSM ≥ 10 kPa by TE or results of liver imaging, without overt signs of CSPH. Patients with conditions known to affect results of LSM (ALT > 5 × ULN, liver congestion, extrahepatic biliary obstruction, infiltrative liver neoplasms) were excluded. Results: Seventy six (76) patients were included: 78.9% males, mean age 62 years, 36.8% suffered from alcoholic, 30.3% nonalcoholic fatty liver disease, 14.5% chronic viral hepatitis, 30.3% were obese, 52.6% had HVPG ≥ 10 mmHg, 56.6% had platelet count ≥ 150 × 109/L. LSM ≥ 25 kPa had 88.9% specificity (95% CI 73.9–96.9) to rule in, whereas Plt ≥ 150 + LSM ≤ 15 kPa had 100% sensitivity (95% CI 91.1–100) to rule out CSPH. Conclusion: By using these simple noninvasive criteria 49/76 (64.5%) patients could be classified correctly for the presence/absence of CSPH, thus obviating the need for HVPG measurements.

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