Platelet count to spleen diameter ratio for prediction of esophageal varices in liver cirrhosis in Addis Ababa, Ethiopia: a cross sectional institutional multicentered study
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Date
2024-04
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Addis Ababa University
Abstract
Background - Liver cirrhosis is the end stage of progressive liver fibrosis as a consequence of
chronic liver inflamma/on wherein the normal hepa/c architecture is replaced by regenera/ve
hepa/c nodules, which eventually leads to liver failure. Cirrhosis without any symptoms is termed
as compensated cirrhosis. Complica/ons such as ascites, variceal bleeding, and hepa/c
encephalopathy herald the onset of decompensated cirrhosis. Gastroesophageal varices are the
hallmark of clinically significant portal hypertension
Objec ve -the aim of this study is to assess the accuracy of PC/SD ra/o as noninvasive predictor
of esophageal varices in pa/ents with liver cirrhosis of different e/ologies in Ethiopia
Method -cross sec/onal retrospec/ve analy/c study was conducted in pa/ents who visited Tikur
Anbesa hospital from January 1, 2019 to December 30, 2023.data was collected by chart review
and direct pa/ent interview with structured ques/oner through Kobo toolbox. The data was
exported to SPSS 26 for analysis and data clearance. ROC curve was ploGed for SD, PLT count and
PC/SD ra/o to get the sensi/vity, specificity PPV, NPV, LR+ and LR-.
Result: among 140 par/cipants in this study 67% were males. The median age of par/cipants was
40.5(IQR:31-54). HBV (38%) was the commonest cause of cirrhosis followed by cryptogenic
cirrhosis and HCV which account for 28% and 16% of the par/cipants respec/vely. 117(83.6%) of
par/cipants have endoscopic evidence of esophageal varices and 72(51.1%) of par/cipants have
gastric varices. decompensated cirrhosis and platelet count are associated with presence of EV
on mul/variate analysis with adjusted OR: 12.63 (95% CI (3.16-67.58, P=0.001) and 0.14 (95% CI
(0.037-0.52, P=0.004) respec/vely. PC/SD ra/o less than 1119 has sensi/vely of 86.32% and
specificity of 70% with AUC:0.835 (95% CI (0.736-0.934, p<0.001). platelet count of less than
133000 and SD of more than 160.5mm have sensi/vity of 93.68% and 31.62%, specificity of
37.78% and 100% and AUC value of: 0.815 (95% CI (0.718-0.913, P<0.001) and 0.712 (95% CI
(0.605-0.82, P=0.001) respec/vely. PC/SD ra/o was superior to platelet count and spleen
diameter alone in predic/ng EV presence.
Recommenda on: Prospec/ve, mul/center studies involving larger and more homogeneous
pa/ent groups are warranted to validate the efficacy of these non-invasive tests within our
popula/on.
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Keywords
Platelet count, Liver Cirrhosis, Diameter Ratio, Esophageal Varices