PLATELET SPLEEN INDEX IS A NON-INVASIVE PREDICTOR OF GASTROESOPHAGEAL VARICES IN PATIENTS WITH CIRRHOSIS.

Abstract

ABSTRACT
BACKGROUND: In individuals with liver cirrhosis, the platelet count to spleen diameter
(PC/SD) ratio is a reliable, noninvasive predictor of esophageal varices. The goal of this study
was to investigate the diagnostic accuracy, sensitivity, and specificity of the platelet spleen index
in cirrhotic patients for the identification of esophageal varices. MATERIAL AND METHOD:
A descriptive comparative cross-sectional study was conducted in the Department of
Gastroenterology, Military Hospital, Rawalpindi, Pakistan, from 10 February 2018 to 9 August
2018. The study comprised 170 cirrhotic individuals in total. Necessary investigations, such as
complete blood count (platelets count), abdomen ultrasonography, and upper GI endoscopy,
were done. Two milliliters of venous blood was taken in an EDTA vacutainer tube for platelets
count, which was determined through an automated hematology analyzer (XN-1000, Sysmex,
Japan). Abdomen ultrasound and endoscopy were performed at the radiology department. SPSS
was used to gather and analyse data, and the findings were presented in tables, graphs, and
charts. RESULTS: Of the 170 patients, 94 (55.3%) were male and 76 (44.7%) were female, with
a mean age of 55.0 ± 9.8 years. The majority of the patients had hepatitis C (142, 83.5%),
followed by hepatitis B (20, 11.8%), cryptogenic cirrhosis (8, 4.7%), and Wilson's disease (2,
1.2%). Grades of esophageal varices were as follows: 24 patients (14.2%) were in grade I, 46
patients (27%) were in grade II, 63 patients (37%) were in grade III, and 37 patients (21.8%) had
no esophageal varices. There were 118 patients (69.4%) in Child's Pugh stage A, 44 patients
(25.9%) in stage B, and 8 patients (4.7%) in grade C. The sensitivity was 73.6%, specificity
100%, positive predictive value 100%, negative predictive value 51.3%, diagnostic accuracy
79.4%, and likelihood ratio 78.3. CONCLUSION: Platelet Spleen Index is a straightforward,
inexpensive, and non-invasive predictor of varices. The adoption of a non-invasive method to
identify gastroesophageal varices might minimise the incidence of invasive
esophagogastroduodenoscopies