Validation of Aspartate Aminotransferase to Platelet Ratio for Diagnosis of Hepatic Fibrosis and Prognostic Prediction of Infants with Biliary Atresia after Portoenterostomy

Abstract

Objectives: We aimed to evaluate the role of aspartate aminotransferase to platelet ratio in the diagnosis of liver fibrosis and its prognosis after surgery in infants with biliary atresia. Methods: This retrospective study was conducted using the medical records of patients diagnosed with biliary atresia who underwent surgery and liver biopsy in Mofid Children's Hospital from 2008 to 2016. The sampling method was complete enumeration and all patients admitted to the hospital in these 8 years were selected as the sample. In this study, an author-made checklist was used. According to data available in the archives of Mofid Children's Hospital, a total of 100 patients with preoperative diagnosis of biliary atresia entered the study. The obtained data were analyzed using descriptive statistics and inferential statistics. The significance level in this study was considered to be 0.05. Results: A total of 100 patients were enrolled in this study, with 64 male patients and 36 female. The patients gave birth at a minimum of 29 weeks and a maximum of 40 weeks. The gestational age was significantly related to the final diagnosis of the disease among children (p = 0.011). With a cut off value of aspartate aminotransferase to platelet ratio of 0.95, 25 patients (50%) with biliary atresia were in the group of significant fibrosis (F4, cirrhosis) and the others were in the non-significant fibrosis group (p value = 0.021). Conclusions: In our study, aspartate aminotransferase to platelet ratio was calculated and showed significant relationship to the final diagnosis based on liver biopsy categorizations among infants with Biliary Atresia after Portoenterostomy.

APRI and FIB-4 indices as diagnostic noninvasive scores for prediction of severe fibrosis in patients with biliary atresia

“…Also, Imanzadeh et al . [ 31 ] reported that higher APRI levels were seen in patients with significant fibrosis and the cirrhotic group. Furthermore, other variables such as gestational age, birth weight, positive C reactive protein (CRP), the need for respiratory support, liver biopsy categorizations, HIDA scans, and cholangiography (based on patency of the bile duct) were all associated with the final diagnosis.…”