Validation of albumin, bilirubin, and platelet criteria for avoiding screening endoscopy in patients with advanced fibrosis

AIM The albumin, bilirubin, and platelet (ABP) criteria was proposed to avoid screening endoscopy for detecting high-risk varices (HRV) and it has high diagnostic accuracy. We conducted the retrospective cross-sectional study to verify the diagnostic accuracy. METHODS A total of 610 patients with advanced fibrosis were enrolled in the study. ABP criteria is defined as follows; albumin > 4.0g/dl, bilirubin 114,000/μl. RESULTS Background liver disease were hepatitis C/hepatitis B/nonalcoholic fatty liver disease (NAFLD) /others:405 (66.4%) / 67 (10.5%) /78 (12.8%) /60 (10.3%). One hundred five patients (17.2%) had HRV. In multivariate analysis, serum bilirubin 4.0g/dl (HR: 2.56, 95%CI: 1.7-3.8), and platelet > 114,000/μl (HR: 3.52, 95%CI: 2.1-5.8) levels were independently associated with no presence of HRV. When examined ABP criteria, 200 patients (32.8%) fulfilled the criteria, and 194 patients had no HRV (positive predictive value [PPV]: 97.0%) When classified by etiologies (hepatitis C/hepatitis B/nonalcoholic fatty liver disease), PPV were 97.7/100/92.0%, respectively. CONCLUSIONS ABP criteria is easy to examine because it uses only standard laboratory tests, and it can be available to screening patients who might avoid endoscopy regardless of etiologies.