The relationship between the size of varices and platelet count/spleen size ratio in cirrhotic patients

Öztürk, Oğuzhan

doi:10.14744/nci.2016.60362

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Outcomes of individuals with EV showed that P/S was associated with significant varices with a sensitivity of 82%. 16 A meta-analysis by Ying et al, showed that the post-test likelihood for varices was 87% if the PSR ratio was <909 but only 9% if the PSR ratio was 909 or above. PSR also exhibited good EV diagnostic accuracy in individuals with compensated cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Platelet count/splenic diameter ratio: Analysis of its capacity as a predictor of the existence of esophageal varices in liver cirrhosis

Natarajan M,

Palanikumaran V,

Vasantha Kalyani D

et al. 2023

Asian J Med Sci

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Background: Endoscopic screening for esophageal varices (EV) is suggested for all cirrhotic patients. Patients with steady liver function should have a screening endoscopy every 2 years if no varices are found. In addition, a liver function test should be performed yearly for those with worsening liver function. Aims and Objectives: The study aimed to investigate non-invasive parameters’ predictive efficacy, such as Platelet count/splenic diameter ratio (PC/SD ratio), by diagnosing EV in cirrhotic patients. Materials and Methods: A Prospective, analytical, single-center study was conducted on 50 patients admitted to Government Rajaji Hospital, Madurai, with cirrhosis between March 2021 and August 2021. Patients with cirrhosis histories and clinical characteristics were admitted to the medical ward of Government Rajaji Hospital. The ultrasonogram (for splenic diameter) and a platelet count were performed on all 50 patients. Results: Thirty-three of the 50 patients had EV during upper gastrointestinal endoscopy. A platelet count/splenic diameter ratio of <900 was found in 33 patients. The two remaining patients have seen a ratio of >900. Therefore, the study’s total of 33 patients had a ratio of <900. Varices were absent in 2 of them. The mean platelet count/spleen diameter ratio of patients without varices was 948.98, and with varices it was 826.9. Hence, using a ratio of 870 as a cutoff, 96% of patients with varices were detected (sensitivity: 94.12% and specificity: 93.94%). Conclusion: This study suggests that a lower Platelet count/splenic diameter ratio (PC/SD ratio) identifies patients needing endoscopy for esophagal varices preventative therapy. Platelet count, spleen bipolar diameter, and PSR are non-invasive, cost-friendly diagnostics.

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Section: Discussionmentioning

confidence: 99%

Platelet count/splenic diameter ratio: Analysis of its capacity as a predictor of the existence of esophageal varices in liver cirrhosis

Natarajan M,

Palanikumaran V,

Vasantha Kalyani D

et al. 2023

Asian J Med Sci

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“…There are five grades of esophageal varices from Grade I to Grade V on the basis of size, risk of rupture and bleeding, presence of red sign and changes in distal esophagus. Studies found that the chance of developing esophageal varices and its severity in cirrhotic patient is minimized if there is high platelet count (12). Although platelet count is a cost effective method to detect the presence and severity of esophageal varices in cirrhotic patient (13) but very few of the data is available so the aim of the current study was to find out the association between mean platelet count and the grading of esophageal varices in patients with liver cirrhosis.…”

Section: Introductionmentioning

confidence: 95%

Association Between Platelet Count and Grading of Esophageal Varices in Patients with Liver Cirrhosis

Mahmood¹,

Khan²,

Memon³

et al. 2023

PJMHS

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Background: Upper GI endoscopy is the gold standard technique for diagnosing esophageal varices and to assess the risk of bleeding but is invasive in nature, costly, time consuming and burden for the department. Besides this platelet count is also an important tool to predict the esophageal varices in cirrhotic patient and it is a highly accurate test. it has been noted that platelet count in cirrhotic patients with esophageal varices, is less than 100,000/cmm but very few of the data is available so the aim of the current study was to find out the association between mean platelet count and grading of esophageal varices in patients with liver cirrhosis. Methods: A descriptive cross-sectional study was conducted at the medicine department of Jinnah Postgraduate Medical Center (JPMC), Karachi. For testing platelet count the blood sample was sent to the pathology laboratory of the hospital. Gastroenterologist performed the upper gastrointestinal endoscopy to grade the esophageal varices. Data was analyzed by using the Statistical Package for Social Science (SPSS) version-20. ANOVA with Post-Hoc Tuckey test was applied to find out the correlation between the variables. p-value less than 0.05 was considered as significant. Results: The mean age of the study participants was 34.9±8.6 years. Majority of the study participants were male (61.1%) as compared to their counterparts. The mean platelet count among the study participants was 113,200±29000 /u L majority of cirrhotic patients included in the study were having grade III of esophageal varices (39.5%). It has been noted that mean platelet count decreased with increasing grade of esophageal varices and the association was significant. Cirrhotic patients having Grade I esophageal varices were having near normal mean platelet count but those who were in Grade V of esophageal varices, having markedly decreased platelet count as compared to Grade I, II, III and IV. Conclusion: It can be concluded that the mean platelet count is significantly inverse association with the grading of esophageal varices, as low as the platelet count, worst the esophageal varices in patients with liver cirrhosis. So testing mean platelet count can be used for screening purpose of esophageal varices as it is a cost effective test. Keywords: Cirrhosis, Esophageal varices, Mean Platelet count,

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“…Splenomegaly is often used radiologically as an indicator of cirrhosis [3]. Many studies also investigated the relationship between size of gastroesophageal varices and platelet count/spleen diameter ratio in cirrhotic patients which also suggested that it could be used as a non-invasive indicator of oesophageal varices [4]. However, a little is published on the actual frequency of hypersplenism and its correlations with liver disease.…”

Section: Introductionmentioning

confidence: 99%

"Hypersplenism in Patients with Liver Cirrhosis and Portal Hypertension: Predictors, and Correlations"

M Hassany

2024

BJSTR

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Background & Aim: Hypersplenism is a common disorder in the setting of liver cirrhosis and portal hypertension (PHT). The presence of hypersplenism suggests more advanced liver disease and an increased risk of complications. This work tried to assess frequency of hypersplenism, correlations, and its predictors in patients with liver cirrhosis and PHT.Patients and Methods: Our study included 303 patients with liver cirrhosis and PHT, and 7 patients were excluded later. The study was carried out at AlRajhi Liver hospital, Assiut University, Egypt, from February 2018 to December 2021. All patients were subjected to full clinical evaluation, laboratory investigations, abdominal Ultrasound, and upper endoscopy. Portal hemodynamic were assessed in 100 patients using doppler ultrasound.Results: A total of 182 patients (61.5%) were found to have hypersplenism. Chronic HCV infection was the causative agent of cirrhosis in most patients (70.9%), with no significant difference between both groups. Chronic co-morbid diseases were not found to affect the development of hypersplenism. We have found significant differences between the hypersplenism and non-hypersplenism group regarding all clinical presentation data. As regards to sonographic findings, patients with hypersplenism had significantly higher splenic diameter (p< 0.001), portal vein diameter, more frequent portosystemic collaterals, portal vein thrombosis and HCC. Also, frequency of ascites, especially marked ascites, was significantly higher (p< 0.001), Regarding portal hemodynamic parameters, portal vein velocity (PVV) and time averaged mean velocity (TAMV), were the doppler parameters which showed significant differences between both groups (p=0.026 & 0.033). Predictors of hypersplenism, were in descending order; ascites, haematemesis and or melena, PV diameter, splenic diameter, PVV, and the presence of portosystemic collaterals. Patients with hypersplenism were categorized according to severity using a scoring index, into mild and moderate/severe, but no significant difference was found between both groups, apart from significant high frequency of varices. Conclusion:Hypersplenism is a common disorder in the setting of liver cirrhosis and PHT. The development of hypersplenism is associated with advanced liver disease, and increased risk of disease related complications. Ascites, haematemesis and or melena, PV diameter, splenic diameter, PVV, and portosystemic collateral may predict the development of hypersplenism. Doppler US may be used as a non-invasive marker for PHT and hypersplenism.

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The relationship between the size of varices and platelet count/spleen size ratio in cirrhotic patients

Cited by 5 publications

References 22 publications

Platelet count/splenic diameter ratio: Analysis of its capacity as a predictor of the existence of esophageal varices in liver cirrhosis

Platelet count/splenic diameter ratio: Analysis of its capacity as a predictor of the existence of esophageal varices in liver cirrhosis

Association Between Platelet Count and Grading of Esophageal Varices in Patients with Liver Cirrhosis

"Hypersplenism in Patients with Liver Cirrhosis and Portal Hypertension: Predictors, and Correlations"

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