PLATELET COUNT TO SPLEEN DIAMETER RATIO AS A NON- INVASIVE PREDICTOR OF ESOPHAGEAL VARICES IN CIRRHOTIC PATIENTS – A DIAGNOSTIC ACCURACY STUDY

Abstract

Introduction Aims: To assess the diagnostic accuracy of platelet count to spleen diameter ratio in identifying the varices and to determine an optimal PC/SD cut off value for predicting high risk esophageal varices. Methods: The study was carried out at Saveetha Medical College, Thandalam with a sample size of 100 patients with cirrhosis. This was a cross-sectional study. Statistical analysis was performed using SPSS version 16. Frequency table, statistical analysis , t test and chi square test were analysed and p< 0.05 was considered statistically significant. Results: A significant difference of ≤1014 was found between the platelet count to spleen diameter ratio and the presence or absence of esophageal varices. The association between the existence of varices and non-invasive markers such as spleen diameter and platelet count was investigated. The only statistically significant factors were the spleen diameter (p < 0.001) and platelet count (p < 0.001). Having varices and having a platelet count/spleen diameter ratio of ≤ 1014 were statistically correlated. Conclusion: The ratio of platelet count to spleen diameter was the most accurate non-invasive metric for EV diagnosis. The data supporting the non-invasive diagnosis is still insufficient, though, to take the role of endoscopy as the diagnostic screening method for EVs in all cirrhotic patients. When endoscopic facilities are not available, the platelet count to spleen diameter ratio may be a helpful non-invasive method for EV diagnosis in liver cirrhosis.