Abstract
<p><strong>Background:</strong> Repeated endoscopy is required to detect &amp; follow up of esophageal varices (OV) in cirrhotic patients. <strong></strong></p><p><strong>Objective:</strong> For discomfort and unwillingness lo do the endoscopy directed us to evaluate liver stiffness measurement (LSM) for lhe prediclion ofO V. <strong></strong></p><p><strong>Methods:</strong> A cross sectional observational study was conducted between July 2010 to July 2011. A total of 50 patients with cirrhosis were divided into three groups. Group-I patients had no varix (n=4), group-II had Grade-I OV (n=23) and group-UI had Grade-II/III OV (n=23 ) at endoscopy. Liver stiffness was measured by fibroscan &amp; data was analyzed by SPSS.</p><p><strong>Results:</strong> Mean age were 35.20 ± 11.36 years with highest frequency 19 (38 %) in 21-30 years age group. Etiologies were different with leading causes includes HBV (76%) followed by HCV (6%), alcohol (2%) and 14% were unknown. Liver stiffness did not significantly differ from group-I &amp; group-II, but was significantly higher in group III than group-II &amp; group I. Liver stiffness was nol accurate in the prediction of grade-I oesophageal variees [Arca under the curve (AUC)] = 23.6%. Liver stiffness at a cut off value 32.52 kPa with sensitivity, specificity, positive predictive value, negative predictive value, accuracy respectively 82.6%, 77.8 %, 76 %, 84%, 80% can predict the Grade-II-Ill oesophageal varices (AUROC = 85.2%). <strong></strong></p><p><strong>Conclusion:</strong> Liver stiffness may be suitable for prediction of Grade-II-III oesophageal varices, not for the screening of the presence of oesophageal varices.</p>
Highlights
Portal hypertension and its consequences are progressively debilitating complications of cirrhosis
In the current study found liver stifftress measurement (LSM) by Fibroscan was not accurate in the prediction of grade-I oesophageal varices (AuRoc - 23.6 %)
This study has shown that liver stiffness can predict Grade-II & III oesophage aI varices, but failed to predict
Summary
Portal hypertension and its consequences are progressively debilitating complications of cirrhosis. Variceal hemorrh age is the most common lethal complication of portal hypertension. Presence of oesophageal varices (OV) correlates with the severity of liver disease; while only 40% of ChildApatients has varices, they are present in 85% of child c patientsl. Patients without varices develop them at a rute of 8oh per yeaf'[3]. Variceal hemorrhage occurs at a yearly tate of 5oh- l5oh, and the most important predictor of hemorrhage is the size of varices, with the highest risk of first hemorrhage (L5% per year) occuffing in patients with large varices[4]. It is recommended that patients with cirrhosis undergo endoscopic screening for varices at the time of diagnosiss and needs. Repeated endoscopy is required to detect & follow up of esophageal varices (ov) in cirrhotic patients
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