Abstract
Predicting the presence and the grade of varices by non-invasive methods is likely to predict the need for prophylactic beta blockers or endoscopic variceal ligation. The factors related to the presence of varices are not well-defined. Therefore, the present study has been undertaken to determine the appropriateness of the various factors in predicting the existence and also the grade of esophageal varices. Patients with diagnosis of liver cirrhosis due to hepatitis C or B were included in a retrospective study between January 2001 and January 2010. All the patients underwent detailed clinical evaluation, appropriate investigations, imaging studies (ultrasound with Doppler) and endoscopy at our center. Five variables considered relevant to the presence and grade of varices were tested using univariate and multivariate analysis (logistic regression). Three hundred and seventy two patients with viral liver cirrhosis were included, with 192 (51.6%) males. Platelet count and abundance of ascites were significantly associated with the presence of esophageal varices. However, abundance of ascites, prothrombin time, diameter of the spleen and portal vein were significantly associated with a large varice. In multivariate analysis, platelet count inferior to 100000 was associated with presence of varices (p = 0.04) and only abundance of ascites was associated with large varice. Low Platelet count (< or equal 100000) is associated with the presence of varices in viral cirrhotic patients and abundance of ascites is correlated with the presence of large varices.
Highlights
Varices are a serious consequence of portal hypertension, and variceal bleeding is a severe complication occurring in up to 30% of patients with cirrhosis
Predicting the grade of varices by non-invasive methods at the time of diagnosis is likely to predict the need for prophylactic beta blockers or endoscopic variceal ligation in patients with cirrhosis and portal hypertension
From January 2001 to January 2012, 372 patients with viral liver cirrhosis were diagnosed at the department of gastroenterology with a slight male predominance 192 (51.6%)
Summary
Varices are a serious consequence of portal hypertension, and variceal bleeding is a severe complication occurring in up to 30% of patients with cirrhosis. The most reliable and accurate method to detect the presence of large esophageal varices is an upper gastrointestinal endoscopy. It is recommended that all patients with established cirrhosis should be screened by upper gastrointestinal endoscopy for the presence of varices at the time of diagnosis. Patients with large varices should be treated with nonselective βeta blockers to reduce the incidence of first variceal bleeding. Predicting the grade of varices by non-invasive methods at the time of diagnosis is likely to predict the need for prophylactic beta blockers or endoscopic variceal ligation in patients with cirrhosis and portal hypertension. The present study has been undertaken to determine the appropriateness of the various clinical, biochemical parameters in predicting the existence and the grade of esophageal varices in viral cirrhotic patients
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