A study of platelet count/ spleen diameter ratio as a predictor of esophageal varices in patients of cirrhosis

Abstract

Background: Todays guidelines are clear that there are no substitute markers to determine the presence and size of esophageal varices, and endoscopy is still the only valid method to investigate varices. Objective: To validate the PC/SD ratio as a predictor of the presence and absence of esophageal varices in patients with chronic hepatopathy. Methodology: This study is an analytical cross-sectional validation study of a diagnostic test. The study was done in cases diagnosed of having hepatic cirrhosis by histology or physical, biochemical, and imaging examinations compatible with the disease and treatment from February 1, 2013 to December 31, 2014. Various hematological, biochemical and radiological work up was done. Results: Of the total cases, 29(70.7%) had PC/SD ratio more than 909 and only 12(29.3%) had less than 909. The sensitivity of PC/SD ratio of 909 in predicting varix is 89.66% and specificity was 75%. Thus it can be considered a good and reliable tool for predicting varices. Conclusion: The use of platelet count/ splenic diameter ratio in cirrhotic patients for screening and follow up for esophageal varices can substantially reduce the cost of health care and discomfort for patients as well as reduce burden of endoscopy unit.