Diagnostic Accuracy of Platelet Count to Spleen Size for Prediction of Esophageal Varices in Patients of Liver Cirrhosis

Abstract

Objective: To determine the diagnostic accuracy of ratio of platelet count to spleen size for prediction of esophageal varices in patients of liver cirrhosis, keeping upper GI endoscopy as gold standard. Materials and Methods: This cross-sectional validation study was carried out in Radiology Department, Combined Military Hospital, Peshawar from February, 2015 to August, 2015.One hundred and fifty patients of either sex, having liver cirrhosis with no episode of gastrointestinal bleeding, scheduled to undergo upper GI endoscopy were selected.Ultrasound abdomen of these patients was carried out and spleen size was determined in millimeters. Platelet count if already not performed was also carried out.Platelet count was divided by the spleen size to obtain the platelet count to spleen size ratio. Close follow up of the patient was done until he/she underwent upper GI endoscopy for diagnosis of esophageal varices. A correlation was performed between the platelet count to spleen size ratio and findings of upper GI endoscopy. Results: Collected data was analyzed through computer software SPSS11.0.The ratio of platelet count to spleen size as a predictor of esophageal varices in patients of liver cirrhosis demonstrated sensitivity of 92.5 %, specificity of 87.5 %, positive predictive value of 93.3 %, negative predictive value of 86.1 % and diagnostic accuracy of 90.8 %. Conclusion: The ratio of platelet count to spleen size as a predictor of esophageal varices in patients of liver cirrhosis is found to be high