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Abstract

Portal hypertension (PH) is responsible for most of the complications that mark the transition from compensated to decompensated cirrhosis, namely variceal hemorrhage, ascites and hepatic encephalopathy. Due to the invasiveness, requirement for advanced technical expertise and high costs associated with HVPG measurements, the introduction of simple, noninvasive screening and diagnostic methods would represent a great clinical advancement. The aim of this work is to evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH. This is a prospective study conducted in the period 2012-2016 including 87 cirrhotic patients. These patients are admitted in the Department of Gastrohepatology at University Medical Center of Tirana Mother Teresa in Tirana and also followed at the policlinic specialities in Tirana. A multivariate logistic model of serum markers showed that AST-to-platelet (PLT) ratio index (APRI), AAR (AST/ALT ratio), Fib-4, fibrosis index (FI) were associated with PH. Also portal blood flow was measured and upper endoscopy was performed. Actually they couldn鈥檛 undergo hepatic venous pressure gradient (HVPG) evaluation. For the diagnosis of cirrhosis AUCs were 0.879 and 0.851 for APRI and FIB-4 respectively and predicted the presence of clinically significant portal hypertension (CSPH), with the highest PPV (94%) and (93.3%). No significant difference was found between them and ROC curve for Echo Doppler (pairwise comparison of ROC APRI ~ Echo_Doppler p=0.8 curves, Echo_Doppler ~ Fib_4 p=0.5). Noninvasive liver fibrosis indexes could be used not only as a first-line screening method for CSPH but also for predicting esophageal varices (EV) in cirrhotic patients as well as proxy for fluxmetric measurement.

Biography

Edlira Elezaj is a Gastrohepatologist in department of Gastrohepatology at University Hospital Mother Tereza, Tirana, Albania since the year 2005. Her occupational skills in General medicine was covered at University of Tirana. From 1998- 2005 her specialization course in Gastro Hepatology, Abdominal Exercise, Digestive Endoscopy were persued at the same university, University of Tirana. She is curently pursuing PhD on Noninvasive evaluation of portal hypertension. She is having 16 years of experience as Gastro-hepatologist from Regional Health Authority of Tirana, Polyclinic of Speciality No.2 and Tirana Continental Hospital. She was invited to many conferences and is Authoring 20 referral articles.

E-mail: edliraelezaj@gmail.com