Online ISSN: 2515-8260

A study on clinical, biochemical and sonological parameters in predicting and grading esophageal varices (ev) in compensated cirrhosis in a tertiary care hospital

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Sandheep Janardhanan* , Saji John Varghese2 , Benoy Sebastian3 , Sunil K Mathai 4

Abstract

Background: Liver cirrhosis and portal hypertension causes esophageal variceal (EV) formation, which can cause variceal bleed with significant mortality. But, endoscopic screening, in a resource constrained setup like India,is not feasible for entire cirrhotic population. Hence there has always been a need for noninvasive predictive factors of EV and hence, umpteen studies have been done in this regard. Materials and Methods: This cross sectional study was conducted in 70 patients with compensated cirrhosis. We assessed parameters like Model of end stage liver disease (MELD) score, fasting blood ammonia, platelet count (PC)and platelet count/bipolar spleen diameter ratio(PC/SD). Results: All these four parameters were found to have significant association in prediction of presence or absence of EV in the study group{ 9.46 ± 1.46 vs 7.56 ± .70, (81.19Umol/l) ± 10.59 vs (52.11Umol/l) ± 9.70, 119346 ± 30986 vs 189611 ± 37595 and 856 ± 140 vs 1460 ± 204, } respectively ( p values <.001).Also, they have significant association in EV grading ,if present, in the univariate analysis ( p values <.001).The cut off values of all these markers were calculated using a receiver operating characteristic( ROC) curve. Conclusion: All these non-invasive parameters can be a useful tool in identifying & targeting cirrhotic with large EV who should undergo screening esophagogastroduodenoscopy (EGDscopy).

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