Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis

• Published in: World journal of gastroenterology : WJG 2014-02, Vol.20 (8), p.2079-2084
• Main Author: Alejandro González-Ojeda Gabino Cervantes-Guevara Manuela Chávez-Sánchez Carlos Dávalos-Cobián Susana Ornelas-Cázares Michel Dassaejv Macías-Amezcua Mariana Chávez-Tostado Kenia Militzi Ramírez-Campos Anaís del Rocío Ramírez-Arce Clotilde Fuentes-Orozco
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alcohol Drinking; Blood Platelets - cytology; Brief; count/spleen; Cross-Sectional Studies; diameter; Endoscopy; Esophageal; Esophageal and Gastric Varices - complications; Female; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Cirrhosis - ethnology; Male; Mexico; Middle Aged; Platelet; Platelet Count; Predictive Value of Tests; ratio; ROC Curve; Sensitivity and Specificity; Spleen - diagnostic imaging; Spleen - pathology; Ultrasonography
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i8.2079

AIM:To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.METHODS:This was an analytical cross-sectional study to validate the diagnostic test for hepatic cirrhosis and was performed between February 2010 and December 2011.Patients with a diagnosis of hepatic cirrhosis were included and stratified using their ChildPugh score.Biochemical parameters were evaluated,and ultrasound was used to measure the longest diameter of the spleen.The platelet count/spleen diameter ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices.Upper gastrointestinal endoscopy was used as the gold standard.Sensitivity and specificity,positive and negative predictive values,and positive and negative likelihood ratios were determined,with the cutoff points determined by receiver-operating characteristic curves.RESULTS:A total of 91 patients were included.The mean age was 53.75±12 years;50(54.9%)were men,and 41(45.0%)women.The etiology of cirrhosis included alcohol in 48(52.7%),virally induced in24(26.3%),alcoholism plus hepatitis C virus in three(3.2%),cryptogenic in nine(9.8%),and primary biliary cirrhosis in seven(7.6%).Esophageal varices were present in 73(80.2%)patients.Child-Pugh classification,17(18.6%)patients were classified as class A,37(40.6%)as class B,and 37(40.6%)as class C.The platelet count/spleen diameter ratio to detect esophageal varices independent of the grade showed using a cutoff value of≤884.3,had 84%sensitivity,70%specificity,and positive and negative predictive values of 94%and 40%,respectively.CONCLUSION:Our results suggest that the platelet count/spleen diameter ratio may be a useful tool for detecting esophageal varices in patients with hepatic cirrhosis.