Abstract :
Background and Aim: Esophageal varices (EV) is well documented to be one of the major complications in cirrhotic patients. All cirrhotic patients should undergo screening for EV. There are several studies about non-invasive markers to predict the presence of EV including platelet count/spleen diameter ratio(P/D ratio). We postulated that whether platelet count/spleen area ratio (P/A ratio), should be better than P/D ratio to predict the presence of EV.
Patients and Methods: This is cross-sectional study in 164 cirrhotic patients without previous va-
riceal hemorrhage. Biochemical study, endoscopic findings, splenic measurement by ultrasonography, P/D ratio and P/A ratio were collected in all patients.
Results: The prevalence of EV was 49% but high grade EV was only 10%. Receiver operating charac-
teristic (ROC) curve was used for analysis, the value of P/D ratio ?1,496 has sensitivity,specificity, negative predictive value (NPV), positive predictive value(PPV) and accuracy of test in about 100%, 36%, 100%, 60%, 67%, respectively. The value of P/A ratio ?21.5 has sensitivity, specificity, NPV, PPV and accuracy of test of in about 100%, 68%, 100%, 75%, 84%, respectively.
Conclusion: The value of P/D ratio ?1,496 and P/A ratio ?21.5 were the good predictors for devel-
oping of EV. Moreover, the P/A ratio has a higher specificity than P/D ratio.
[Thai J Gastroenterol 2006; 7(2): 93-99] |