PLATELET COUNT/SPLEEN DIAMETER RATIO A NON INVASIVE PREDICTOR OF ESOPHAGEAL VARICES IN PATIENTS WITH CIRHOSIS

Abstract

Objective:
To determine the diagnostic value of platelets count/spleen ratio for detection of esophageal varices in cirrhosis patients.
Methodology:
The research was conducted from February 2023 to March 2024 at Liaquat University of Medical & Health Sciences (LUMHS). The sample of 153 cirrhotic individuals of both genders aged 18 to 75 years were incorporated into the research by using non-probability, purposive sampling. Platelet counts, and spleen diameters were measured to calculate the PC/SD ratio. Patients underwent endoscopy to verify the existence of EV. Analysis of data was conducted using SPSS 26.0. The receiver operating characteristic (ROC) curve was performed to evaluate the prediction performance of the PC/SD ratio, with the area under the curve (AUC) computed for sensitivity and specificity.
Results:
The mean ± standard deviation of age of the 153 participants was noted as 53.63±9.02 years. Among them 103 (67.3%) were male and 50 (32.7%) were female. Patients with EV showed significantly reduced PC/SD ratio (p < 0.001). A cutoff of ≥412.50 demonstrated a sensitivity of 95.1% and a specificity of 79.2%, leading to an AUC of 0.737, indicating moderate accuracy. At this cutoff, the positive likelihood ratio was 4.57. Lower cutoff values increased sensitivity but reduced specificity.
Conclusion:
The platelet count-to-spleen diameter (PC/SD) ratio is an easily obtainable, non-invasive predictor of esophageal varices (EV) in liver cirrhosis. These results imply that the PC/SD ratio could be utilized in the routine screening to avoid invasive endoscopy and add an economic value in terms of reducing the cost of healthcare. Additional extensive research with a larger sample size across different study centres in Pakistan is necessary to validate the findings of the current study.
Keywords:
Cirrhosis, Esophageal varices, Platelet count, ROC curve, Spleen