A STUDY ON PLATELET COUNT TO SPLEEN DIAMETER RATIO TO PREDICT ESOPHAGEAL VARICES IN PATIENTS WITH HEPATIC CIRRHOSIS IN A TERTIARY CARE HOSPITAL

Abstract

Background: Cirrhosis instances can appear with a variety of clinical symptoms [1]. The disease is characterized by significant hepatic fibrosis, irreversible parenchymal damage, and the production of regenerative nodules. Gilbert initially created the term "portal hypertension". Cirrhotic livers can cause increased spontaneous blood flow, vasodilation, and hepatic resistance [2]. Esophageal variceal development is a prominent consequence of portal hypertension (PHT) [3].
OBJECTIVES: To study the value of platelet count to spleen diameter ratio as a non-invasive parameter for diagnosing esophageal varices (EVs) in Liver Cirrhosis.
MATERIAL & METHODS: Study Design: Hospital-based, cross sectional study. Study area: The study was conducted in the Department of General Medicine, Shadan Institute of Medical Sciences & Hospital, Hyderabad, Telangana from September 2022 to February 2023. Study population: Outpatients and Inpatients of both Departments of General Medicine and Gastroenterology. Sample size: Study consisted a total of 100 subjects. Sampling Technique: Simple Random technique. Study tools and Data collection procedure: Hundred patients with cirrhosis of liver, attending the medical and gastroenterology wards and outpatient departments, were selected, based on inclusion and exclusion criteria. All patients in the study underwent a full clinical evaluation. Clinical history and physical examination findings were recorded with particular attention to present or previous hematemesis, malena, bleeding per rectum, bleeding tendencies, alcoholism, blood transfusion, intake of hepatotoxic drugs, exposure to Sexually transmitted diseases, IV drug abuse, jaundice, anemia, edema, stigmata of chronic liver disease, dilated abdominal veins, ascites, splenomegaly andencephalopathy.
Results: Relationship between non-invasive parameters like Serum Bilirubin, Serum albumin, Hemoglobin, Platelet count, spleen Bipolar diameter to presence of varices was studied. Of this only Platelet Count (P=0.0001) and Spleen Bipolar diameter (P=0.0002) had statistical significance.
CONCLUSION: The use of Platelet count/Splenic diameter ratio, non-invasive criteria in appropriate subgroups of cirrhotic patients for esophageal varices screening and follow-up can significantly reduce health-care costs and patient pain, as well as the strain on endoscopy units.