The probability of progression to gastroesophageal varices in children with biliary atresia and portal hypertension relies on age, total serum bilirubin concentration, and early endoscopic characteristics. For a study, researchers sought to provide an effort to use these criteria to discover high-risk variants early (HRVs). A model was developed to assess the odds of HRV development at various time intervals based on different combinations of these parameters. In children who did not initially show HRVs, a 10% chance was selected to determine the timing of the next endoscopy. A total of 113 children without HRVs who had their first endoscopy before the age of 8 between 2013 and 2020 were included in the study. A comparison was made with children seen between 1990 and 2012 when this model was not employed. 

In all, 65 of the 113 children had one to five more endoscopies on dates determined by the model. The onset of HRVs was seen in 22 children over a 14-month period, and all but one who received liver transplantation were treated with primary endoscopic prevention. Three more youngsters bled before the next scheduled endoscopy. In the period 1990–2012, as compared to 175 children of the same age range who did not have HRVs, using the model was linked with faster identification of HRVs and fewer endoscopic operations (P=0.0022 and P=0.023, respectively). The findings showed that the reported model might be a valuable tool for the early diagnosis of HRVs, allowing for primary bleeding prevention.