The principle of the method is based on the observation that destruction of red cells in an organ is manifested by progressive increase in radioactive counts over that organ relative to the count rate over other organs and over the heart, reflecting the radioactivity in the blood; thus assessment can be made of the role of the spleen relative to the liver in the destruction of erythrocytes. An accumulation of activity in the spleen suggests that splenectomy might be beneficial and the method has been considered to be a valuable aid in predicting response to splenectomy in the majority of patients with haemolytic anaemia. However, a number of false predictions have been reported by some authors (Schloesser et al, 1957;McCurdy and Rath, 1958;Veeger, Woldring, Van Rood, Eernisse, Leeksma, Verloop, and Nieweg, 1962;Ben-Bassat, Seligsohn, Leiba, Leef, Chaitchik, and Ramot, 1967;Allgood and Chaplin, 1967). These reports indicate the need for a clear understanding of the method before it is used in making a decision for or against splenectomy.

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INTRODUCTION: Non alcoholic Fatty liver disease (NAFLD) is one of the leading cause of chronic liver disease in United States. Combined with diabetes and metabolic syndrome, NAFLD is expected to be the most common cause of liver transplantation. We sought to determine the trend of NAFLD induced cirrhosis in National Population. We also studied the risk of decompensation and in hospital mortality in patients with NAFLD cirrhosis. METHODS: We obtained data from Nationwide Inpatient sample database using International classification of Diseases, the 9th revision, clinical modification codes to identify patients who had diagnosis of Cirrhosis and NAFLD from 2006-2014. We also obtained data on decompensation and patient's mortality in patients who had cirrhosis with history of NAFLD. Decompensated cirrhosis was defined as patients with cirrhosis and having one or more of these conditions: hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, ascites or variceal bleeding. Data was extrapolated using SPSS statistics software. RESULTS: Total of 4,226,236 patients had diagnosis of cirrhosis, 114,972 had NAFLD diagnosis. Trend of NAFLD is significantly increasing from 2007 (1.2%) to 2014 (3%). 2,313,524 (54.7%) of patients had decompensated cirrhosis. NAFLD was present in 3.2% (74,557) of patients in decompensated cirrhosis as compared to 2.1% (40,415) of patients who had compensated cirrhosis (P < 0.001). In hospital mortality of patients in decompensated cirrhosis with history of NAFLD was 4.3% and without history of NAFLD was 7.9% (P < 0.001). On Univariate analysis, patients with NAFLD were at low risk of in hospital death as compared to patients without NAFLD OR 0.53 (CI: 0.513–0.550). CONCLUSION: There has been significant increasing trend of NAFLD induced cirrhosis in last decade. NAFLD is associated with increased risk of cirrhosis decompensation as compared to other causes of cirrhosis. Interestingly, NAFLD cirrhotic patients have lower in hospital mortality as compared to patients with other causes of cirrhosis.

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