PREDICTION OF ESOPHAGEAL VARICES IN COMPENSATED CHRONIC LIVER DISEASE PATIENTS BY USING FIBROSCAN, SPLEEN SIZE AND PLATELET COUNT

Abstract

Background - In this study, we aim to identify the noninvasive methods like Fibroscan, spleen size, platelet count, and their combinations in correlating and predicting esophageal varices. Methods - This observational study includes patients diagnosed with Compensated Chronic liver disease presented for the rst time. Relevant physical examination and clinical parameters were assessed, including complete hemogram, biochemical workup, liver stiffness using Fibroscan, USG measurement of spleen long axis diameter, Upper GI endoscopy for variceal screening, and grading. Results – A signicant correlation between platelet count and the presence of varices was noted (P<0.001), with a cut-off count of 150 x 109/L, with a sensitivity of 88.9% and a specicity of 97.2%, And for high-risk varices the optimal Cut-off was 128 x 109/L. The Cut-off point for Spleen diameter for the presence of varices was 14.15cm with 94.7% sensitivity and 84.1% specicity with a signicant pvalue < 0.001. High-risk varices optimal Cut-off was 14.65cm. Similarly, the best cut-off point for liver stiffness and the presence of varices was 21kPa, with a sensitivity of 96.0% and a specicity of 97.4% with a signicant p-value < 0.001, and for high-risk varices was 25.5kPa. A statistically signicant correlation was observed between the Liver stiffness spleen diameter platelet score (LSPS) in predicting varices and highrisk varices with the best cut-off value of 2.05 and 3.11, respectively Conclusion - Our study concludes that Fibroscan, Spleen Size, and platelet count, individually and Combined LSP Score is a valuable tool in predicting the presence of esophageal varices and severity. From all these parameters, we could identify the subset of patients who require endoscopy screening for esophageal varices.