Can we consider the right hepatic lobe size/albumin ratio a noninvasive predictor of oesophageal varices in hepatitis C virus-related liver cirrhotic Egyptian patients?

Esmat, Serag; Omarn, Dalia; Rashid, Laila

doi:10.1016/j.ejim.2011.11.010

Cited by 24 publications

(29 citation statements)

References 28 publications

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“…Similar findings are reported in studies by Sheta EAE et al (40) & Said HEE et al (38) . Esmat S et al (23) found that PC/SD ratio had higher accuracy than RLLD/albumin ratio which is again in agreement with our study.…”

Section: Discussionsupporting

confidence: 93%

“…It was significantly increased as the grade of EV increased. Similar significant positive correlation between RLLD/albumin ratio & EV had been reported by Alempijevic et al (12) , Said et al (38) , Rye et al (39) , Esmat et al (23) , Mostafa et al (14) , Laeeq et al (13) & Sheta EAE et al (40) We found in our present study that at the best cut-off value of 4.272 for RLLD/albumin ratio, the sensitivity was 74.4%, specificity was 94.4%, PPV was 98.4%, NPV was 44.7% and accuracy was 78% for the prediction of EV. AUC was 0.835 signifying its good predictability for EV.…”

Section: Discussionsupporting

confidence: 85%

“…e.g. Giannini et al (24) , Alempijevic et al (12) , Esmat et al (23) , Mostafa et al (14) and several other studies had found a significant negative correlation of PC/SD ratio with presence & size of EV. PC/SD ratio was introduced by Giannini et al (9) in 2003, so as to link thrombocytopenia to splenomegaly to introduce a variable that takes into consideration that thrombocytopenia is mainly due to hypersplenism secondary to portal hypertension.…”

Section: Discussionmentioning

confidence: 94%

“…Similarly, Chalasani et al (18) in 1999, concluded that large EVs are predictable in thrombocytopenic patients who have enlarged spleen. In 2012, Esmat et al (23) found a highly statistically significant correlation of the presence and grade of EV with the splenic diameter (p<0.001). The presence of splenomegaly in cirrhotic patients is mainly related to portal hypertension & main mechanism of thrombocytopenia is splenic sequestration & pooling.…”

Section: Discussionmentioning

confidence: 98%

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A Comparative Evaluation of Liver Lobe Size/Albumin Ratio and Platelet Count/Spleen Diameter Ratio as Non-Invasive Predictors of Oesophageal Varices in Patients With Liver Cirrhosis

Charan¹,

Garg²,

Chander³

et al. 2017

jemds

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BACKGROUNDOesophageal varices (EV) development is among the major complications of liver cirrhosis. Therefore, the current guidelines recommend screening of all liver cirrhosis patients for EV by endoscopy, but repeated endoscopic examinations are unpleasant for the patients, are not cost-effective and pose additional burden to endoscopic units. Therefore, non-invasive predictors of EV have been studied.The aim is to comparatively evaluate platelet count/spleen diameter (PC/SD) ratio, right liver lobe diameter (RLLD)/albumin ratio & left liver lobe diameter (LLLD)/albumin ratio as the non-invasive predictors of EV & their grading in patients with liver cirrhosis. MATERIALS AND METHODSThis study included 100 patients of liver cirrhosis which were subjected to laboratory investigations including platelet count & serum albumin concentration, abdominal ultrasound including measurement of RLLD, LLLD & spleen diameter and upper gastrointestinal endoscopy. PC/SD ratio, RLLD/albumin ratio & LLLD/albumin ratio were then calculated & comparatively evaluated statistically for their correlation with the presence & grading of EV. RESULTSPC/SD ratio, RLLD/albumin ratio and LLLD/albumin ratio had highly significant correlations with the presence and grading of EV (p<0.001 for each). The sensitivity, specificity and accuracy of PC/SD ratio in prediction of EV was 90.2%, 88.9% and 90% respectively at the best cut-off value of 1167.25 as calculated by applying receiver operating characteristic (ROC) curve. [AUC (Area under curve) =0.965]. The sensitivity, specificity and accuracy of RLLD/albumin ratio in prediction of EV was 74.4%, 94.4% and 78% respectively at the best cut-off value of 4.272 (AUC=0.835). The sensitivity, specificity and accuracy of LLLD/albumin ratio in prediction of EV was 89%, 83.3% and 88% respectively at the best cut-off value of 1.939 (AUC=0.931). PC/SD ratio, having the highest sensitivity, accuracy & area under ROC curve, was the best predictor of EV, followed by the LLLD/albumin ratio, which was further followed by RLLD/albumin ratio. CONCLUSIONPC/SD ratio, RLLD/albumin ratio & LLLD/albumin ratio are cost-effective noninvasive parameters that can provide accurate information pertinent to predict the presence & grading of EV in liver cirrhosis patients & amongst them PC/SD ratio is the b est predictor of EV, followed by LLLD/albumin ratio, which is further followed by RLLD/albumin ratio. KEYWORDSLeft Liver Lobe Diameter/Albumin Ratio, Platelet Count, Right Liver Lobe Diameter/Albumin Ratio, Spleen Diameter, Upper Gastrointestinal Endoscopy. HOW TO CITE THIS ARTICLE: Charan S, Garg R, Chander R, et al. A comparative evaluation of liver lobe size/albumin ratio and platelet count/spleen diameter ratio as non-invasive predictors of oesophageal varices in patients with liver cirrhosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

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A Comparative Evaluation of Liver Lobe Size/Albumin Ratio and Platelet Count/Spleen Diameter Ratio as Non-Invasive Predictors of Oesophageal Varices in Patients With Liver Cirrhosis

Charan¹,

Garg²,

Chander³

et al. 2017

jemds

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“…In addition, cirrhosis can result in esophageal varices, which may induce fulminant massive hemorrhage of the upper gastrointestinal tract. Two recent studies reported that the ratio of right liver lobe diameter on ultrasonography to albumin could be a noninvasive parameter providing accurate information pertinent to determination of presence of esophageal varices [6,26] . As demonstrated in this study, RV, LMV and LLV were larger, and CV, RV/ALB, LMV/ALB, LLV/ALB and CV/ALB were lower in cirrhotic patients with esophageal varices than without esophageal varices.…”

Section: Discussionmentioning

confidence: 99%

Albumin and magnetic resonance imaging-liver volume to identify hepatitis B-related cirrhosis and esophageal varices

Chen

et al. 2015

WJG

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Platelet count, spleen length, and platelet count-to-spleen length ratio for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis

Colli

Gana

Yap

et al. 2017

Cochrane Database of Systematic Reviews

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Can we consider the right hepatic lobe size/albumin ratio a noninvasive predictor of oesophageal varices in hepatitis C virus-related liver cirrhotic Egyptian patients?

Cited by 24 publications

References 28 publications

A Comparative Evaluation of Liver Lobe Size/Albumin Ratio and Platelet Count/Spleen Diameter Ratio as Non-Invasive Predictors of Oesophageal Varices in Patients With Liver Cirrhosis

A Comparative Evaluation of Liver Lobe Size/Albumin Ratio and Platelet Count/Spleen Diameter Ratio as Non-Invasive Predictors of Oesophageal Varices in Patients With Liver Cirrhosis

Albumin and magnetic resonance imaging-liver volume to identify hepatitis B-related cirrhosis and esophageal varices

Platelet count, spleen length, and platelet count-to-spleen length ratio for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis

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