Non-invasive predictors of the presence of large oesophageal varices in patients with cirrhosis

Thomopoulos, K.; Labropoulou-Karatza, Chryssoula; Mimidis, Konstantinos; Katsakoulis, Evangelos; Iconomou, Gregoris; Nikolopoulou, V.

doi:10.1016/s1590-8658(03)00219-6

Cited by 165 publications

(127 citation statements)

References 19 publications

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“…2,4 In our study, it was observed that mean platelet count in grade-I EV was 142568.42±6640.369/mm 3 3 . Platelet count showed a highly statistical significant inverse correlation with the grading of esophageal varices, which is in agreement with Thomopulos et al 5 Esophageal varices were graded according to Paquet 6 . Grading System and Gastric varices were graded according to Sarin et al 7 .…”

Section: Fig-2supporting

confidence: 90%

Correlation of portal vein diameter, splenomegaly and thrombocytopenia with gastro-espohageal varices in cirrhotic patients

Singh¹,

Sehgal²,

Singh³

et al. 2017

Int. J. Curr. Res. Med. Sci

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Background: Portal hypertension is one of the complications of chronic liver disease due to cirrhosis liver. Portal vein diameter, Splenomegaly and Thrombocytopenia can be used as Non-Invasive markers for the presence of gastro-esophageal varices in cirrhotic patients. Early detection of gastro-esophageal varices can prevent the UGI variceal bleed in cirrhotic patients. Hence the correlation of portal vein diameter, splenomegaly and thrombocytopenia with Gastro-Esophageal Varices helps in early detection of gastro-esophageal varices. Method: This study was conducted on 100 patients of cirrhosis and investigations for platelet count, ultrasonography for portal vein diameter and upper GI endoscopy for esophageal varices detection were undertaken in all the patients.. Results: Our study demonstrated that thrombocytopenia, presence of portal hypertension with splenomegaly and portal vein diameter are strong predictors of developing gastro-esophageal varices in cirrhotic patients. Conclusion: in cirrhotic patients gastro-esophageal varices has direct correlation with Portal hypertension and inverse correlation with platelet count.

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Section: Fig-2supporting

confidence: 90%

Correlation of portal vein diameter, splenomegaly and thrombocytopenia with gastro-espohageal varices in cirrhotic patients

Singh¹,

Sehgal²,

Singh³

et al. 2017

Int. J. Curr. Res. Med. Sci

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“…It may be explained according to the issue that palpable spleen as well as LEV may both be related to the presence of a higher portal pressure. Different factors found to be important for this purpose included splenomegaly [23][24][25][26][27][28] , thrombocytopenia [23][24][25][26][27][28][29][30] , ascites [25,27] , hepatic encephalopathy [25] , serum albumin concentration [30] , serum bilirubin levels [30] , and Child-Pugh score [27,28] . Thus, the results of our study are consistent with those of the previously published data.…”

Section: Resultsmentioning

confidence: 99%

Portal hemodynamics as predictors of high risk esophageal varices in cirrhotic patients

Tarzamni¹,

Somi²,

Farhang³

et al. 2008

WJG

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AIM:To evaluate portal hypertension parameters in liver cirrhosis patients with and without esophageal varices (EV). METHODS:A cohort of patients with biopsy confirmed liver cirrhosis was investigated endoscopically and with color Doppler ultrasonography as a possible noninvasive predictive tool. The relationship between portal hemodynamics and the presence and size of EV was evaluated using uni-and multivariate approaches. RESULTS:Eighty five consecutive cirrhotic patients (43 men and 42 women) were enrolled. Mean age (± SD) was 47.5 (± 15.9). Portal vein diameter (13.88 ± 2.42 vs 12.00 ± 1.69, P < 0.0005) and liver vascular index (8.31 ± 2.72 vs 17.8 ± 6.28, P < 0.0005) were found to be significantly higher in patients with EV irrespective of size and in patients with large varices (14.54 ± 1.48 vs 13.24 ± 2.55, P < 0.05 and 6.45 ± 2.78 vs 10.96 ± 5.05, P < 0.0005, respectively), while portal vein flow velocity (13.25 ± 3.66 vs 20.25 ± 5.05, P < 0.0005), congestion index (CI) (0.11 ± 0.03 vs 0.06 ± 0.03, P < 0.0005), portal hypertensive index (2.62 ± 0.79 vs 1.33 ± 0.53, P < 0.0005), and hepatic (0.73 ± 0.07 vs 0.66 ± 0.07, P < 0.001) and splenic artery resistance index (RI) (0.73 ± 0.06 vs 0.62 ± 0.08, P < 0.0005) were significantly lower. A logistic regression model confirmed spleen size (P = 0.002, AUC 0.72) and portal hypertensive index (P = 0.040, AUC 0.79) as independent predictors for the occurrence of large esophageal varices (LEV). CONCLUSION:Our data suggest two independent situations for beginning endoscopic evaluation of compensated cirrhotic patients: Portal hypertensive index > 2.08 and spleen size > 15.05 cm. These factors may help identifying patients with a low probability of LEV who may not need upper gastrointestinal endoscopy.

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“…Several studies (13)(14)(15)(16)(17)(18)(19) have shown that platelet count and spleen diameter correlate well with the presence of EVs. However, in patients with chronic liver disease, the presence of a decreased platelet count may depend on several factors other than portal hypertension, such as shortened mean platelet lifetime, decreased thrombopoietin production or myelotoxic effects of alcohol or hepatitis viruses (20).…”

Section: Discussionmentioning

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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Non-invasive predictors of the presence of large oesophageal varices in patients with cirrhosis

Cited by 165 publications

References 19 publications

Correlation of portal vein diameter, splenomegaly and thrombocytopenia with gastro-espohageal varices in cirrhotic patients

Correlation of portal vein diameter, splenomegaly and thrombocytopenia with gastro-espohageal varices in cirrhotic patients

Portal hemodynamics as predictors of high risk esophageal varices in cirrhotic patients

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

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