EVendo Score for Esophageal Varices

Pre-endoscopy estimate of the likelihood of esophageal varices needing treatment in cirrhosis.

INR

AST

U/L

Platelet count

x10^3/uL

Blood urea nitrogen (BUN)

mg/dL

Hemoglobin

Ascites present

Complete the fields above to see the result.

When to use

Deciding which cirrhotic patients can safely defer screening upper endoscopy for esophageal varices.

Formula

EVendo = [(8.5 x INR + AST/35) / (platelets[x10^3/uL]/150 + BUN[mg/dL]/20 + hemoglobin[g/dL]/15)] + 1 if ascites present (else +0). Score <=3.90 suggests low risk of varices needing treatment.

Pearls and pitfalls

Developed using machine-learning variable selection from routine labs plus ascites status, without requiring elastography.
Intended to reduce unnecessary screening EGDs; still requires external validation in the specific population before altering practice.

References

Dong TS, et al. Machine learning-based development and validation of a scoring system for screening high-risk esophageal varices. Clin Gastroenterol Hepatol. 2019;17(9):1894-1901.e2.