Simple Predictors of Gastro Esophageal Varices Bleeding in Cirrhotic Patients

Abstract

Background: Liver stiffness (LS), measured by transient elastography (TE), was correlated with portal hypertension as well as the presence of esophageal varices (EV). Objective: The aim of the current study was to examine non-invasive markers that serve as "predictors" of esophageal varices (EV) and variceal hemorrhage in individuals with liver cirrhosis. Patients and methods: A total of 250 Egyptian HCV associated cirrhotic persons, age more than 18, body mass index (BMI) under 35 with no history of ascites, GIT bleeding, HCC, abdominal collaterals, Portal, or splenic vein thrombosis by ultrasonography were recruited in our study. They were divided into Group I (no varices), Group II (small varices) and Group III (large varices). Results: All groups were age and BMI matched, in group III platelet count was lower and MELD score was higher significantly than groups I and II (115.4±41.6 vs 149.6±60.6 and 132.1±44.9) and (12.1±2.9 vs 9.1+2.5 and 10.1+2.2) respectively. Hemoglobin, platelet count and serum albumin were significantly decreased in group III in comparison with groups I and II (P-value <0.001), while serum bilirubin and INR levels were significantly more in group III than in groups I and II (P-value <0.001). AFP was significantly increased in group II than groups I and III (P-value 0.008). Conclusion:Our findings demonstrate the potential for using predictors to stratify cirrhotic individuals for the likelihood of developing extensive EV, hence enhancing the cost-effectiveness of screening endoscopy.