Prediction of oesophageal varices in patients with compensated cirrhosis: A novel scoring system |
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| Authors: | Emad Emam Ayman Ramadan Mohamad Badway Hesham Atia Mohamad Hamid Abo Warda Heba Hassen Gawish |
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| Affiliation: | 1. Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain;2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain;3. Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Canada;4. Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Vall d''Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain;1. Department of Surgery, Madigan Army Medical System, Madigan Health System, 9040a Fitzsimmons Dr, Tacoma, WA 98431, USA;2. University of Cincinnati, Cincinnati, OH, USA;3. Catholic Health Services of Long Island, Rockville Centre, NY, USA;4. Case Western, Cleveland, OH, USA;5. University of Massachusetts Memorial Medical Center, Worcester, MA, USA;1. Department of Tropical Medicine and Gastroenterology, Qena Faculty of Medicine, South Valley University, Qena, Egypt;2. Department of Tropical Medicine and Gastroenterology, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt;3. Department of Tropical medicine and Gastroenterology, Sohag Faculty of Medicine, Sohag University, Egypt;1. Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India;1. Department of Mathematics, University of Latvia, Riga LV-1002, Latvia;2. Institute of Mathematics and Computer Science, University of Latvia, Riga LV-1586, Latvia |
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| Abstract: | Background and study aimsPatients with liver cirrhosis are recommended to undergo an evaluation of oesophageal varices to assess their risk of bleeding. Predicting the presence of oesophageal varices through non-invasive means may reduce the number of unnecessary endoscopies. This study was designed to develop a predictive model for varices in patients with Child-Pugh A liver cirrhosis.Patients and methodsRetrospective analysis was performed on 70 patients with compensated cirrhosis. Clinical and laboratory parameters Child-Pugh class and platelet count were assessed. Ultrasonographic characteristics of splenic axis and portal vein diameter were noted. The data were assessed by univariate analysis and a multivariate logistic regression analysis.ResultsWe found the prevalence of oesophageal varices in patients with child A liver cirrhosis to be 64.3%. Platelet count, splenic axis, portal vein diameter, platelet count/splenic axis ratio, portal vein congestive index, and renal resistive index were found to be significantly associated with the presence of oesophageal varices on univariate analysis. A platelet count of 100,000, platelet count/splenic axis ratio <900, renal resistive index ?0.68, and a portal vein congestive index of ?0.07 had the highest discriminating value, at which the number of true positive patients was highest and the number of false positive patients was lowest (50% and 3%, 63% and 13%, 41% and 0%, 57% and 1%, respectively). Multivariate analysis identified platelet count, platelet count/splenic axis ratio, renal resistive index, portal vein congestive index as independent factors for the presence of oesophageal varices.ConclusionOur data suggest that a new score system composed of some laboratory and ultrasonographic parameters may predict the presence of varices in patients with Child-Pugh A cirrhosis, and that the score system may help physicians to identify patients who would most likely benefit from screenings for oesophageal varices. |
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