Non-Invasive Predictors of Esophageal Varices in Patients with Cirrhosis of Liver-A Prospective Study

Abstract

Mamunur Rashid, Sultana Jasmin

Background: Liver disease particularly chronic liver disease is one of the major public health problem, accounting for significant morbidity and mortality worldwide. Among the different complications, gastro-esophageal variceal bleeding is the deadliest complications of advanced liver disease and have been described in 50% of patients with liver cirrhosis.

Aim: To identify the non-invasive predictors of esophageal varices in patients with cirrhosis of liver, so as to reduce number of unnecessary endoscopies. Methods: Ninety two patients with cirrhosis of liver irrespective of etiology were analysed prospectively from October 2019 to March 2020. Appropriate clinical, biochemical and ultrasonographic parameters were selected as variables to compare with esophageal varices. The data were assessed by univariate and multivariate analysis.

Results: Univariate analysis of the studied parameters showed that decreased platelet count, albumin levels and platelet count/splenic diameter ratio and increased bilirubin levels, prothrombin time, splenic size, portal vein size were significantly associated with the presence of esophageal varices and their values correlated with increasing size of varices. On multivariate analysis of variables, the independent predictors for the presence of varices were platelet count/splenic size <1433.1, splenic size>115.75 mm.

Conclusion: Platelet count/splenic size<1433.1, Splenic size>115.75 mm are independent noninvasive predictors of esophageal varices in patients with cirrhosis of liver.

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