Predicting Esophageal Varices in Liver Cirrhosis: The role of Platelet Count/Spleen Diameter Ratio

Introduction: Esophageal varices and variceal hemorrhage are commoncomplications of Liver cirrhosis leading to morbidity and mortality. Uppergastrointestinal endoscopy is the gold standard for demonstration of gastroesophageal varices. Endoscopy facilities are not available in rural areashowever the burden of liver cirrhosis is high. Early prediction of esophagealvarices through non-invasive means may be lifesaving. Therefore this study wasdesigned to identify the relationship between platelet count/splenic bipolardiameter ratio for prediction of presence of esophageal varices. Methods: The study was an observational cross sectional study consistingof 53 patients of liver cirrhosis admitted at Bir Hospital, Kathmandu betweenJuly 2019 to December 2019. Upper gastrointestinal endoscopy was done toconfirm varices. A platelet count/spleen diameter ratio cut-off value of 909 wasevaluated for the diagnosis of esophageal varices. Statistical analysis was doneusing Statistical Package for the Social Sciences 20. Results: Esophageal varices were present in 44(83%) of cases. Small and largevarices were present in 21(39.6%) and 23(43.4%) respectively. Platelet countto splenic diameter ratio with a cut off value of 909 had sensitivity of 54.5%,specificity of 88.9%, positive predictive value of 96% and negative predictivevalue of 22.8% (p=0.018 , CI=95%). Conclusions: Platelet count to spleen diameter ratio can be a good predictorof presence of esophageal varices in patient of liver cirrhosis in the resourcepoor settings.