Predictors of Large Esophageal Varices in Patients With Cirrhosis

Abstract

Our data show that clinical predictors could be used to stratify cirrhotic patients for the risk of large esophageal varices and such stratification could be used to improve the cost effectiveness of screening endoscopy.

Portal hemodynamics as predictors of high risk esophageal varices in cirrhotic patients

“…It may be explained according to the issue that palpable spleen as well as LEV may both be related to the presence of a higher portal pressure. Different factors found to be important for this purpose included splenomegaly [23][24][25][26][27][28] , thrombocytopenia [23][24][25][26][27][28][29][30] , ascites [25,27] , hepatic encephalopathy [25] , serum albumin concentration [30] , serum bilirubin levels [30] , and Child-Pugh score [27,28] . Thus, the results of our study are consistent with those of the previously published data.…”

External Validation of the Platelet Count/Spleen Diameter Ratio for the Diagnosis of Esophageal Varices in Hepatitis C Virus-Related Cirrhosis

“…Firstly, the platelet count/spleen diameter ratio has a greater accuracy as compared to other simple parameters, such as platelet count alone [14][15][16], and this is likely due to the low specificity of platelet count which, in turn, is related to its multi-factorial origin, especially in patients with chronic HCV infection [18,19].…”

“…However, in some countries both accessibility to endoscopy and resources may be limited [11][12][13], and these limitations together with the everincreasing workload on endoscopy units emphasises the need for simple and commonly available parameters that can non-invasively diagnose EV [14][15][16][17]. In many studies, thrombocytopenia was the factor most commonly associated with varices, though it lacked adequate accuracy, likely due to a multifactorial aetiology [18,19].…”

Comparisons between Portosystemic Shunting Modalities in Patients with Liver Cirrhosis and Portal Hypertension

“…In turn, longterm results in PSSh patients are characterized by the absence of rebleeding, thrombosis, and satisfying survival rates: one year, 84.8%; 3 years, 68.6%; 5 years, 51.3%; 10 years, 25.8%. The authors conclude that the performance of selective and partial PSSh is indicated in patients with liver volume more than 1200 sm 3 and positive values of the liver dysfunction index.…”

“…Due to the high incidence of viral hepatitis, as well as the steady growth of factors such as alcohol, drugs or toxic liver injury, its social importance is steadily increasing in many countries. [1][2][3] Although the average age of patients with LC in Europe and the USA is 55±10 years, in Central Asian region tendency to "rejuvenation" of the disease, up to 25 years old and younger. 1 Often determined by the fatal prognosis, the two main complications of LC are: bleed-ing of esophageal and gastric varices (EGV) and progression of liver failure with encephalopathy.…”