External Validation of the Platelet Count/Spleen Diameter Ratio for the Diagnosis of Esophageal Varices in Hepatitis C Virus-Related Cirrhosis
- 2 July 2008
- journal article
- research article
- Published by Springer Nature in Digestive Diseases and Sciences
- Vol. 54 (3) , 654-660
Abstract
Background Screening for esophageal varices (EV) is an important part of the diagnostic workup of cirrhotic patients. Aims To independently validate the use of the platelet count/spleen diameter ratio for the non-invasive diagnosis of EV in patients with HCV-related cirrhosis and in a sub-group of patients with compensated disease. Methods A platelet count/spleen diameter ratio cut-off value of 909 was evaluated for the diagnosis of EV in the whole population (n = 311) and in patients with compensated disease alone (n = 114). Compensated disease was defined as the absence of ascites as detected by abdominal ultrasound in patients who are not on diuretics and absence of hepatic encephalopathy. Results In the whole cohort (EV prevalence 49.5%), the platelet count/spleen diameter ratio 909 cut-off value had 96.9% positive predictive value, 100% negative predictive value, and 98.4% efficiency for EV diagnosis. In compensated cirrhotics (EV prevalence 26.3%), the platelet count/spleen diameter ratio 909 cut-off showed an excellent negative predictive value (100%) and a positive predictive value of 93.8%. for the diagnosis of EV. Conclusions In patients with HCV-related cirrhosis, the platelet count/spleen diameter may be proposed as a non-invasive tool for EV diagnosis, especially in financially deprived developing countries.Keywords
This publication has 43 references indexed in Scilit:
- Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varicesJournal of Hepatology, 2006
- Review article: thrombocytopenia in chronic liver disease and pharmacologic treatment optionsAlimentary Pharmacology & Therapeutics, 2006
- Color Doppler ultrasonography is reliable in assessing the risk of esophageal variceal bleeding in patients with liver cirrhosisWiener klinische Wochenschrift, 2005
- Evolving Consensus in Portal Hypertension Report of the Baveno IV Consensus Workshop on methodology of diagnosis and therapy in portal hypertensionJournal of Hepatology, 2005
- Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of oesophageal varices in patients with liver cirrhosisGut, 2003
- Prognostic value of the galactose test in predicting survival of patients with cirrhosis evaluated for liver transplantationJournal of Hepatology, 1996
- Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter studyJournal of Hepatology, 1994
- Definitions, methodology and therapeutic strategies in portal hypertensionJournal of Hepatology, 1992
- Prediction of the First Variceal Hemorrhage in Patients with Cirrhosis of the Liver and Esophageal VaricesNew England Journal of Medicine, 1988
- Transection of the oesophagus for bleeding oesophageal varicesBritish Journal of Surgery, 1973