Laboratory and Ultrasonographic predictors of oesophageal varices in cirrhotic patients

Galal, Ghada Moustafa; Zaghloul, Amr Mohamed; Aref, Rania Ashraf

doi:10.21608/smj.2018.33804

Laboratory and Ultrasonographic predictors of oesophageal varices in cirrhotic patients

Document Type : Original Article

Authors

¹ Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University.

² Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Sohag University

10.21608/smj.2018.33804

Abstract

Portal hypertension in cirrhosis results from progressive fibrotic remodeling of the liver, which increases the resistance to hepatic sinusoidal blood flow. Increased portal venous pressure causes esophageal and gastric varices, which contribute substantially to cirrhosis-related morbidity and mortality.
The gold standard in the diagnosis of varices esophagogastroduodenoscopy (EGD) but identification of non –invasive predictors of oesophageal varices (OVs) will allow upper gastrointestinal (GIT) endoscopy to be carried out only in selected group of patients .
Different non-invasive parameters including clinical, laboratory and sonographic predictors were suggested an alternative approach to perform selective screening endoscopy only in patients at high risk.
Objective: Our objective is to evaluate whether the NIHCED (non-invasive hepatitis C related cirrhosis early detection) score and the right lobe diameter to albumin ratio can predict the presence of esophageal varices in patients with liver cirrhosis.
Patients and method: This prospective study included seventy-five patients with liver cirrhosis, all patients were evaluated clinically and ultrasonographically. complete blood count, liver function tests, calculation of NIHCED score and right lobe diameter to albumin ratio. Upper GIT endoscopy were done to all of them for detection of oesophageal varices.
Results In total 75 patients were included (51 males and 24 females) with mean age 53.11±9.89. All 75 patients were segregated into two groups those with oesophageal varices and those without oesophageal varices.
Roc curve analysis of NIHCED score was applied to both goups with a cut off score of >45. It had a sensitivity of 70%, specifity of 78%, and diagnostic accurancy of 74% with an AUC of 0.77 (95% CI, 0.66-0.86).
Roc curve analysis of right lobe diameter to albumin ratio was applied to both groups with a cut off score of >2.80. It had a sensitivity of 80%, specifity of 53%, and diagnostic accurancy of 67% with an AUC of 0.67 (95% CI , 0.55-0.77).
Conclusions: The NIHCED score and right lobe diameter to albumin ratio were simple non-invasive predictors of presence of varices in patients with liver cirrhosis.

Keywords

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