Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database

Kovalak, Mary; Lake, Jeremy; Mattek, Nora; Eisen, Glenn M.; Lieberman, David; Zaman, Atif

doi:10.1016/j.gie.2006.08.023

Cited by 171 publications

(108 citation statements)

References 7 publications

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“…However, most current guidelines (26)(27)(28) recommend that all cirrhotic patients be screened by upper gastrointestinal endoscopy for the presence of EVs at the time of diagnosis. This argues against the accuracy of noninvasive predictors of EVs.…”

Section: Resultsmentioning

confidence: 99%

Platelet Count to Spleen Diameter Ratio for the Diagnosis of Esophageal Varices: Is It Feasible?

Baig

Nagaraja

Varma

et al. 2008

Canadian Journal of Gastroenterology

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AIM: To study the value of platelet count to spleen diameter ratio as a noninvasive parameter for diagnosing esophageal varices (EVs) in liver cirrhosis.METHODS: The laboratory and ultrasonographic variables were prospectively evaluated in 150 patients with liver cirrhosis. Only stable patients were included in the study. Patients with active gastrointestinal bleeding at the time of admission were excluded. All patients underwent screening upper gastrointestinal endoscopy.RESULTS: The platelet count, spleen diameter and platelet count to spleen diameter ratio in patients with EVs were significantly different from patients without EVs. The platelet count to spleen diameter ratio had the highest accuracy among the three parameters. By applying receiver operating characteristic curves, a platelet count to spleen diameter ratio cut-off value of 1014 was obtained, which gave positive and negative predictive values of 95.4% and 95.1%, respectively. The accuracy of this cut-off value as evaluated by applying receiver operating characteristic curves was 0.942 (95% CI 0.890 to 0.995).CONCLUSION: Among the noninvasive parameters studied, platelet count to spleen diameter ratio had the highest accuracy for diagnosing EVs. However, the evidence for the noninvasive diagnosis is not yet sufficient to replace endoscopy as a diagnostic screening tool for EVs in all cirrhotic patients. The platelet count to spleen diameter ratio may be a useful tool for diagnosing EVs in liver cirrhosis noninvasively when endoscopy facilities are not available.

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Section: Resultsmentioning

confidence: 99%

Platelet Count to Spleen Diameter Ratio for the Diagnosis of Esophageal Varices: Is It Feasible?

Baig

Nagaraja

Varma

et al. 2008

Canadian Journal of Gastroenterology

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“…These findings were supported by (33), who reported that nearly half of patients with newly detected liver cirrhosis have associated varices every year, new varices are extend or the preexisting varices deteriorate in 7% of patients, and first bleeding occurs in 12% of clients each year.…”

Section: Factors Affecting Esophageal Varices Patients Compliance To mentioning

confidence: 61%

Factors Affecting Esophageal Varices Patients Compliance to Therapeutic Regimen and Suggested Guidelines

Taha¹

2017

IOSR JNHS

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“…The morphological characteristics of RC signs were classifi ed according to the general rule of the Japanese Research Society for Portal Hypertension. 3,4 Each RC sign was subclassifi ed into red wale marking, cherry-red spot, and hematocytic spot. The diagnosis of bleeding from esophageal varices was done when spurt bleeding, oozing, or a white nipple sign suggesting a fi brin plug 24,25 was found.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 Other investigators have reported that esophagogastric varices are found more frequently in patients with more severe liver disease, 3 and variceal bleeding subsequently brings fatal events with a high incidence of 13%-35%. [4][5][6] Therefore, the ability to predict and prophylax bleeding from esophagogastric varices is clinically important for the management of patients with liver cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

“…The Child-Pugh score, showing the severity of liver disease, has been reported in particular to be a very reliable marker for variceal bleeding by many investigators. 3,8,11,12 The pressure and fl ow of the portal and hepatic veins have also been shown as signifi cant predictors for variceal bleeding. [13][14][15][16][17] As a local factor, the endoscopic fi nding of varices and the presence or absence of the red color (RC) sign 18,19 is an important predictor for variceal bleeding, 8,9,11 and it is well known that variceal bleeding is derived from the rupture of this RC sign.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does gastroesophageal reflux have an influence on bleeding from esophageal varices?

et al. 2008

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Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database

Cited by 171 publications

References 7 publications

Platelet Count to Spleen Diameter Ratio for the Diagnosis of Esophageal Varices: Is It Feasible?

Platelet Count to Spleen Diameter Ratio for the Diagnosis of Esophageal Varices: Is It Feasible?

Factors Affecting Esophageal Varices Patients Compliance to Therapeutic Regimen and Suggested Guidelines

Does gastroesophageal reflux have an influence on bleeding from esophageal varices?

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