Abstract
Background: Screening guidelines recommend that all patients who are newly diagnosed with cirrhosis should be screened for esophageal varices (EV). This study aimed at predicting the presence of esophageal varices among Egyptian hepatitis C cirrhotic patients by a combination of albumin-bilirubin grade and platelet count score (ALBI-Platelet score). Methods: This study was performed on 150 cirrhotic patients. Eighty- seven patients with hepatitis C virus (HCV) related cirrhosis and esophageal varices formed Group (A), while Group (B) consisted of sixty-three patients with HCV related cirrhosis and no esophageal varices. Full metabolic profile, Complete blood count (CBC), ultrasonography, and endoscopy were done. Results: There was a significant difference between studied groups regarding serum bilirubin, serum albumin and platelet count. The cutoff point of platelets count as a predictor for esophageal varices among studied groups was <154.5. The cutoff value for albumin-bilirubin (ALBI) score as a predictor for esophageal varices of any size was -1.67 with 52.9% sensitivity, 59.6% specificity, 47% negative predictive value (NPV) and 64% positive predictive value (PPV). The ALBI-Plt score >3 had 42.5%, specificity 63.5%, negative predictive value 40% and positive predictive value 65%. The cutoff value for the ALBI score representing large-sized esophageal varices was -1.27. The ALBI-Plt score >4 for large-sized varices had sensitivity 61.9%, specificity 55%, negative predictive value 59%, positive predictive value 50%. Conclusion: ALBI-Platelet score is a non-costly, readily available and reliable new non-invasive predictor of the presence of EV that could easily be used in screening for the presence of esophageal varices and risky large-sized esophageal varices in cases of hepatitis C Virus related hepatic cirrhosis, lessening the need for endoscopic screening.
Highlights
Cirrhosis is a liver disease characterized replacement of liver tissue by fibrosis and regenerative nodules [1]
The Open Biomarkers Journal, 2022, Volume 12 3 difference between the two studied groups (p-value = 0.054); there was no significant difference between the two studied groups as regards the model for endstage liver disease (MELD) score (P-value = 0.7) (Table 1)
There was a significant difference as regards the longitudinal splenic diameter (LSD) between the two studied groups, with the mean being longer in patients from group A (16.21 ± 3.83 cm and median 16 cm) than those from group B;(14.50 ± 4.03 cm and median 13cm) (P-value is 0.01)
Summary
Cirrhosis is a liver disease characterized replacement of liver tissue by fibrosis and regenerative nodules [1]. The loss of liver function is the result of these changes: Chronic hepatitis C (HCV), chronic hepatitis B (HBV), and non-alcoholic fatty liver disease (NAFLD) are the most common causes of cirrhosis [2, 3]. Portal hypertension (PH) is characterized as a greater than 5 mmHg increase in the portal venous pressure gradient (PVPG) between the portal vein (PV) and inferior vena cava (IVC) as a result of changes in portal resistance and portal inflow [4]. All patients newly diagnosed with cirrhosis should be screened for EV, according to current recommendations. Screening guidelines recommend that all patients who are newly diagnosed with cirrhosis should be screened for esophageal varices (EV). This study aimed at predicting the presence of esophageal varices among Egyptian hepatitis C cirrhotic patients by a combination of albumin-bilirubin grade and platelet count score (ALBI-Platelet score)
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