TY - JOUR AU - Khadka, Dipendra AU - Prajapati, Sushil AU - KC, Sudhamshu AU - Shrestha, Jeetendra Kaji AU - Karki, Niyanta AU - Jaishi, Bikash AU - Regmi, Kiran AU - Khadka, Sandip PY - 2017/12/31 Y2 - 2024/03/28 TI - Significance of Non-Invasive Markers as Predictor of Esophageal Varices in Liver Cirrhosis JF - Journal of Nepal Medical Association JA - J Nepal Med Assoc VL - 56 IS - 208 SE - Original Article DO - 10.31729/jnma.3379 UR - http://jnma.com.np/jnma/index.php/jnma/article/view/3379 SP - 412-6 AB - <p class="p1"><span class="s1"><strong>Introduction: </strong></span>Upper gastro-intestinal endoscopy remains the gold standard for screening for esophageal varices but it has its own limitations. It is an invasive, expensive and uncomfortable procedure and needs clinical expertise. Accordingly, this study was conducted to establish the role of non-invasive markers for prediction of esophageal varices in liver cirrhosis.</p><p class="p1"><span class="s1"><strong>Methods: </strong></span>A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function test, liver ultrasound and upper gastro-intestinal endoscopy were done for all patients to detect esophageal varices and to correlate with different non-invasive markers.</p><p class="p1"><span class="s1"><strong>Results: </strong></span>Total 191 patients of liver cirrhosis were studied after exclusion. Platelet count of 92082.00±43435.83/mm<sup>3 </sup>and spleen size of 144.21±10.71 mm was found to be good predictors of presence of EV (P≤0.001). Significant association between Child-Turcotte-Pugh class and presence of varices was observed (P≤0.001). AST/ALT ratio with cutoff value of 1.415 showed sensitivity of 82.4% and specificity of 36.4%. APRI at a cutoff value of 1.3 showed a sensitivity of 83.2% and specificity of 50%.</p><p class="p1"><span class="s1"><strong>Conclusions: </strong></span>Platelet count, spleen size and Child-Turcotte-Pugh class are good predictors of presence of esophageal varices in patients with liver cirrhosis. AST/ALT ratio and APRI score are not good substitutes for upper gastro-intestinal endoscopy.</p><p class="p3">&nbsp;</p><p class="p3"><span class="s2"><strong>Keywords:</strong></span><em><span class="Apple-converted-space">&nbsp; </span>esophageal varices; liver cirrhosis; non-invasive markers; portal hypertension; upper gastro-intestinal.</em></p> ER -