Predictive Value Of Platelet Count To Spleen Diameter Ratio For Oesophageal Varices

BACKGROUND AND AIM- Oesophageal variceal bleeding is a frequently occurring complication in patients with end stage liver disease and cirrhosis with very high mortality rates. The diagnosis and management of oesophageal varices is dependent on repeated upper gastrointestinal endoscopy which is invasive in nature. However, it presents a problem in terms of non-compliance by patients and its invasive nature. Hence, in this study we explored the use of “ratio of platelet count to spleen diameter” to predict oesophageal varices in patients with cirrhosis as it is a non-invasive parameter and would result in better compliance. Although such a parameter cannot negate the importance of upper gastrointestinal endoscopies but may be used as an adjuvant to ascertain adequate interval for monitoring thereby ensuring optimal utilization of resources. METHODS: This study was conducted in a tertiary care hospital in Delhi between August 2018 to 2019 and we computed the ratio of platelet count to spleen diameter in all patients to predict oesophageal varices in cirrhotic patients. It was carried out on 81 patients. The diagnosis of liver cirrhosis was made on the basis of clinical evidence of decompensation or varices and/or radiological evidence of nodularity of liver and collaterals and/or fibroscan values suggestive of cirrhosis. Platelet count was recorded and spleen diameter was measured and the ratio was then calculated. In order to confirm oesophageal varices in all these patients, an upper gastrointestinal endoscopy was done as a standard test. RESULTS: Results showed predominance of male participants at 72.8% (n=59). Overall, the incidence of oesophageal varices was 69.1%. In 38.3% participants, alcoholic liver disease was the cause of cirrhosis. The cut off ratio of ≤975 was present in 65.4% patients and a total 69.1% patients had varices on endoscopy. Thus, the ratio of