Platelet count/spleen diameter ratio for non-invasive diagnosis of oesophageal varices: is it useful in compensated cirrhosis?

Dig Liver Dis. 2012 Jun;44(6):504-7. doi: 10.1016/j.dld.2011.12.016. Epub 2012 Feb 9.

Abstract

Aim: To assess the diagnostic accuracy of the platelet count/spleen diameter ratio for identification of oesophageal varices and/or hypertensive gastropathy in patients with compensated cirrhosis.

Methods: Platelet count/spleen diameter ratio was calculated in 87 consecutive patients with compensated cirrhosis. A new cut-off with the highest sensitivity and specificity for the presence/absence of oesophageal varices and/or hypertensive gastropathy was identified. Performance of the platelet count/spleen diameter ratio considering previously reported cut-off values were then tested in our population.

Results: A platelet count/spleen diameter ratio <936.4 had the best sensitivity and specificity for the diagnosis of oesophageal varices and for all endoscopic findings of portal hypertension. A value lower than 936.4 allowed identification of 64.5% of patients with oesophageal varices and 66.7% of patients with any sign of portal hypertension; a value higher than 936.4 excluded oesophageal varices in 64.3% of patients and any sign of portal hypertension in 68.6% of patients.

Conclusions: In patients with compensated cirrhosis, the platelet count/spleen diameter ratio is not a useful parameter to avoid unnecessary upper endoscopy, independently of the cut-off.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophageal and Gastric Varices / blood
  • Esophageal and Gastric Varices / diagnosis*
  • Esophageal and Gastric Varices / etiology
  • Esophagoscopy
  • Female
  • Gastroscopy
  • Humans
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / physiopathology
  • Male
  • Middle Aged
  • Organ Size
  • Platelet Count*
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Spleen / pathology*