Platelet count/Spleen diameter ratio and AST/ALT ratio as non invasive parameters for the detection of esophageal varices in patients with liver cirrhosis

Dr. M.K.Sagar; Dr.V.Sriram; Dr. V.Hari Priya; Dr.V Ramanarasimham; Dr.K.L.Behera

Volume : VII, Issue : IX, September - 2018

Platelet count/Spleen diameter ratio and AST/ALT ratio as non invasive parameters for the detection of esophageal varices in patients with liver cirrhosis

Dr. M. K. Sagar, Dr. V. Sriram, Dr. V. Hari Priya, Dr. V Ramanarasimham, Dr. K. L. Behera

Abstract :

Esophageal varices in liver cirrhosis is a major complication increasing its morbidity and mortality. Prevalence of esophageal varices in liver cirrhosis range from 60–80 %. Patients with cirrhosis should be screened for varices with esophageal endoscopy. Endoscopy is an invasive procedure and also may not be affordable for ordinary people in developing countries. This study aims to find out diagnostic efficacy of non invasive marker for detecting esophageal varices.

Aim: To assess the value of Platelet count/spleen diameter(PLC/BPD) ratio and Aspartate transaminase/Alanine transaminase (AST/ALT) ratio as a non invasive marker for esophageal varices in patient with cirrhosis.

Materials and Methods: It is a Diagnostic test evaluation study of 18 months duration conducted in 140 cirrhotic patients admitted in medicine ward of maharajah’s institute of medical sciences,nellimarla. Data collected and analysed using SPSS. ROC curve was drawn with different cut offs for Platelet count/Spleen thickness and AST/ALT ratio.

Result: PLC/ BPD ratio have sensitivity 74 % and specificity 88% which is statistically significant with a p value <.001. This ratio have a cut off value 919 with area under ROC curve 0.908 which denotes a good test. AST/ALT ratio have sensitivity 74% specificity 82 % which is statistically significant with a p value < .001 and the ratio have a cut off value 1.30 with area under ROC curve 0.794

Conclusion :Platelet count/spleen diameter ratio and AST/ALT ratio may be used as non invasive marker for esophageal varices in cirrhotic patients