COMPARISON OF EVENDO SCORE, AIMS-65 SCORE AND GLASGOWBLATCHFORD SCORE FOR THE PREDICTION OF OESOPHAGEAL VARICES IN CIRRHOTIC PATIENTS

Background: Oesophageal varices (EV) are a major complication of portal hypertension in cirrhotic patients, with variceal bleeding contributing signicantly to morbidity and mortality. Although endoscopic screening is recommended, a substantial proportion of procedures are low-yield. Non-invasive tools such as the EVendo score, AIMS-65, and Glasgow-Blatchford Score (GBS) may help identify patients at higher risk, potentially reducing unnecessary endoscopies. This study aimed to compare the diagnostic performance of these three scores in predicting the presence of oesophageal varices and varices requiring treatment (VNT) in cirrhotic patients. Methods: This prospective observational study was conducted at Madras Medical College, India, from January to December 2024. A total of 149 adult cirrhotic patients underwent laboratory evaluation and screening upper GI endoscopy. The EVendo, AIMS-65, and GBS were calculated for each patient using standard denitions. Diagnostic accuracy for predicting EV and VNT was assessed using receiver operating characteristic (ROC) curve analysis, with the area under the curve (AUC) compared using DeLong's test. Sensitivity, specicity, positive predictive value (PPV), and negative predictive value (NPV) were determined at predened cut-offs (EVendo > 3.9, AIMS-65 ≥ 2, GBS > 2). Results: Oesophageal varices were detected in 93 (62.4%) patients, of whom 61 (65.6%) had varices requiring treatment. The EVendo score demonstrated the highest diagnostic accuracy for predicting EV (AUC = 0.83) compared with AIMS-65 (AUC = 0.72) and GBS (AUC = 0.68) (p = 0.01). For VNT prediction, EVendo again outperformed other scores (AUC = 0.79) versus GBS (0.72) and AIMS-65 (0.68) (p = 0.04). At the EVendo > 3.9 threshold, sensitivity, specicity an NPV for variceal detection were 87.1%, 78.3% and 80.6% respectively, for VNT, sensitivity was 84.4%, specicity 76.1%, and NPV 88.5%. Conclusion: The EVendo score outperformed AIMS-65 and GBS in predicting both oesophageal varices and varices requiring treatment among cirrhotic patients. Its high diagnostic accuracy and negative predictive value support its use as a non-invasive triage tool to safely reduce low-yield screening endoscopies. With further multicentre validation and implementation studies, EVendo could become a valuable component of routine cirrhosis esophageal varices screening, enabling personalised surveillance, reducing procedural burden, and optimising resource utilization.