Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis

Mandhwani, Rajesh; Hanif, Farina; Haque, Muhammad Manzoor Ul; Wadhwa, Rajesh Kumar; Luck, Nasir Hassan; Mubarak, Muhammad

doi:10.1515/jtim-2017-0025

Cited by 14 publications

(22 citation statements)

References 14 publications

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“…In our study there were 122 (76.25%) patients with esophageal varices, similar results were found in studies from Egypt, Serbia, India, and Pakistan. 15,19-21 Whereas a cross-sectional study from Lahore, Pakistan by Khan and colleagues 22 showed only a 22.3% of patients with esophageal varices. Another study conducted on 197 patients from Peshawar showed esophageal varices in 32% of the patients.…”

Section: Discussionmentioning

confidence: 96%

“…In our study, a cut-off value of 4.42 was taken, while according to the Child-Turcotte-Pugh grades we observed 67 (41.88%) patients with grade A, followed by 61 (38.12%) patients with grade B, and 32 (20%) patients with grade C, which is consistent with the findings reported in previous studies. 19,21 A Serbian study by Alempijevic et.al. 19 showed that 24.5% of the patients with no esophageal varices were identified by upper GI endoscopy, 22.3% had grade I esophageal varices, 33% had grade II esophageal varices, 16% had grade III esophageal varices, and 4.3% had grade IV esophageal varices.…”

Section: Discussionmentioning

confidence: 99%

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The Right Liver Lobe Size/Albumin Concentration Ratio in Identifying Esophageal Varices among Patients with Liver Cirrhosis

Akram

Soomro

Magsi

2018

Middle East J Dig Dis

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BACKGROUND It is necessity to work more on non-invasive markers like right liver lobe size/albumin concentration ratio for predicting esophageal varices. We aimed to see the right liver lobe/albumin ratio in identifying esophageal varices among patients with cirrhosis caused by hepatitis B and C. METHODS A cross-sectional study was conducted among all indoor patients admitted to the Department of Internal Medicine, Pakistan Atomic Energy Commission, General Hospital, Sector H-11/4 Islamabad, Pakistan, during May-December 2016. A non-probability purposive sampling technique was used for data collection. Diagnosed cases of cirrhosis caused by hepatitis B and C virus infection aged 25 years or more were included. A pre-designed questionnaire was used for data collection. Statistical analysis was done using SPSS software version 20. RESULTS A total number of 160 patients were included. Mean ± SD age was 56.04 ± 10.22 years, while 96 (60%) were men. Child-Turcotte-Pugh grades showed 41.88% of the patients with grade A, followed by grade B (38.12%), and grade C (20%). Esophageal varices were observed in 76.25% of the patients. The sensitivity was 86.89%, while specificity was 78.95%. The positive predictive value was 92.98% (95% confidence interval [CI] = 86.64% - 96.91%) and negative predictive value was 65.22% (CI = 49.75% - 78.64%) with a diagnostic accuracy of 85%. CONCLUSION The use of the studied non-invasive markers of portal hypertension particularly the right liver lobe size/albumin concentration ratio, can help physicians to restrict the use of endoscopic screening only to patients presenting a high probability of esophageal varices.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

The Right Liver Lobe Size/Albumin Concentration Ratio in Identifying Esophageal Varices among Patients with Liver Cirrhosis

Akram

Soomro

Magsi

2018

Middle East J Dig Dis

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“…Its prevalence has been reported to range from 11% to 98%. 62 However, bleeding is relatively less common, with 10.8% of patients having chronic bleeding and only 2.5% acute bleeding. 63 Platelet counts are lower in patients with PHG.…”

Section: Non-variceal Gastrointestinal Bleedingmentioning

confidence: 99%

“…The diagnostic accuracy of platelet count to spleen diameter ratio in 111 cirrhotic patients for sensitivity, specificity, PPV, NPV, and accuracy of PSR were 87.23%, 5.88%, 83.67%, 7.69%, and 74.7%, respectively. 62 The right liver lobe-diameter-to-albumin ratio and platelet-count-to-spleendiameter ratio are noninvasive predictors of the presence and severity of portal hypertensive gastropathy. 62 There are no reports on the impact of thrombocytopenia on bleeding from PHG.…”

Section: Non-variceal Gastrointestinal Bleedingmentioning

confidence: 99%

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<p>Clinical Implications of Thrombocytopenia for the Cirrhotic Patient</p>

Sigal¹,

Sherman

Jesudian

2020

HMER

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Thrombocytopenia is a frequent complication in patients with cirrhosis. As many as 84% of patients with cirrhosis have thrombocytopenia, and it is an independent variable indicative of advanced disease and poor prognosis. Although there is great concern that it may aggravate bleeding during surgical procedures, there is limited evidence to inform decisions regarding the treatment of cirrhotic patients with thrombocytopenia undergoing invasive procedures. Finally, there is evidence that platelets play a significant role in liver regeneration. In this report, the clinical implications of thrombocytopenia in cirrhotic patients are reviewed. The utility of platelet counts in the prognosis of cirrhosis and relationship to complications of advanced liver disease, including portal hypertension, esophageal varices, and hepatocellular carcinoma. The impact of low platelet counts on bleeding complications during invasive procedures is outlined. Finally, the role of platelets and potential adverse impact in liver regeneration is reviewed.

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RLLB/Alb ratio: a promising noninvasive diagnostic marker in assessing esophageal varices in cirrhotic patients

Chowdhury

Palit

Mozibullah

et al. 2022

Clinical Laboratory Analysis

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Background Endoscopy has long been widely used to screen for esophageal varices (EV) in cirrhotic patients. Recurrent endoscopy is a significant burden for the healthcare system of the endoscopic unit as well as uncomfortable and high costs for patients. This study intended to prognosticate Right Liver Lobe Diameter/Serum Albumin Ratio (RLLD/Alb) as a non‐invasive approach in the early diagnosis of EV among chronic liver disease (CLD) Bangladeshi patients enrolled in a specific hospital. Participants and Methods A total of 150 admitted patients with CLD were included in the study. Patients were subjected through a comprehensive biochemical checkup and upper digestive endoscopic or ultrasonographic inspection. The correlation was evaluated between the RLLD/Alb ratio and esophageal varices grades. Results The upper digestive endoscopy demonstration among 150 patients resulted in no EV in 18%, while 24% of patients was identified as EV grade I, 20% as grade II, 20% as grade III, and 18% patients as grade IV. The mean value of the RLLD/Alb ratio was 4.89 ± 1.49 (range from 2.30 to 8.45). The RLLD/Alb ratio diagnosed the EV employing the cut‐off value of 4.01 with 85.3% sensitivity and 68.8% specificity. Furthermore, it was positively correlated with the grading of EV, when this ratio increased the grading of EV increases and vice versa (r = 0.630, p < 0.001). Conclusion The RLLD/Alb ratio is a non‐invasive parameter giving exact guidance relevant to the ascertainment of the existence of EV and their grading in chronic liver disease patients.

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Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis

Abstract: PSR is better predictor of PHG than RLAR but at the expense of relatively lower specificities and NPV likely because of underlying pathophysiology (portal hypertension) which is similar for esophageal varices, PHG, and ascites.

Cited by 14 publications

References 14 publications

The Right Liver Lobe Size/Albumin Concentration Ratio in Identifying Esophageal Varices among Patients with Liver Cirrhosis

The Right Liver Lobe Size/Albumin Concentration Ratio in Identifying Esophageal Varices among Patients with Liver Cirrhosis

<p>Clinical Implications of Thrombocytopenia for the Cirrhotic Patient</p>

RLLB/Alb ratio: a promising noninvasive diagnostic marker in assessing esophageal varices in cirrhotic patients

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