Correlation between Platelet Count and Grading of Esophageal Varices in Liver Cirrhosis Patients: A Meta-Analysis

Abstract

BACKGROUND: Esophageal varices are a major complication of liver cirrhosis. Esophageal varices bleeding is life-threatening and an urgent medical emergency. Low platelet count and esophageal varices are common findings in liver cirrhosis. Platelet count is suggested as a non-invasive screening tool to predict the grading of esophageal varices in liver cirrhosis patients. Several studies have found a correlation between platelet count and grading of esophageal varices in liver cirrhosis patients. However, the results are conflicting.
 AIM: This meta-analysis aimed to evaluate the correlation between platelet count and the grading of esophageal varices in liver cirrhosis patients.
 METHODS: A systematic literature search was performed through the database search from PubMed, SCOPUS, Ovid EMBASE, and EuropePMC to obtain all relevant articles with the following search terms: "correlation" and "platelet" or "thrombocytopenia" AND "esophageal varices" and "liver cirrhosis" or "chronic liver disease" that were published within the year of 2000-2021. Articles were collected by using PRISMA flow diagrams. The data were extracted from the eligible study within inclusion and exclusion criteria. The quality of each study was assessed using the Newcastle Ottawa Scale (NOS). A meta-analysis was conducted to determine the overall pooled correlation coefficient (r) and 95% confidence interval (CI).
 RESULTS: There were a total of 1008 patients from eight included studies. The meta-analysis showed that the pooled correlation coefficient between platelet count and grading of esophageal varices in liver cirrhosis patients was r = -0.42 (95%CI -0.65 to -0.13; p = 0.005; I2 = 96.06%).
 CONCLUSION: There was a moderate negative correlation between platelet count and grading of esophageal varices. Thus, low platelet count may indicate higher grades of esophageal varices in liver cirrhosis patients.