Diagnostic accuracy of platelet count/spleen diameter ratio for detection of esophageal varices in cirrhotic patients taking endoscopy as gold standard

Background: esophageal varices are common in patients with cirrhosis,with an estimated prevalence of 50%. various radiologic and ultrasonographic (us) noninvasive indexes,including spleen size,portal vein velocity (pvv),portal vein diameter,hepatic impedance indexes,splenic impedance indexes,and results of multidetector computed tomographic esophagography,have been putatively shown to be predictive of the severity of esophageal varices aim: to find the diagnostic accuracy of platelet count/spleen diameter ratio for detection of esophageal varices in patients of cirrhosis. study design: cross sectional study setting: all medical wards of mayo hospital,lahore duration of study: six months from: june 2013 to december 2013 results: in our study,23(10.70%) were between 1230 years,93(43.25%) between 3150 years,and 99(46.05%) were between 5180 years,mean±sd was calculated as 46.93±13.22 years,124(57.67%) were females and 91(42.33%) were male,frequency of esophageal varices in patients of cirrhosis (on endoscopy) reveals 131(60.93%) while 84(39.07%) were not recorded with this morbidity and diagnostic accuracy of platelet count/spleen diameter ratio for detection of esophageal varices in patients of cirrhosis we recorded 124(57.67%) true positive,4(1.86%) false positive,80(37.21%) true negative and 7(3.26%) were false negative,sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate was calculated as 96.95%,95.24%,96.88%,91.95% and 94.88% respectively. conclusion: we found diagnostic accuracy of platelet count/spleen diameter ratio for detection of esophageal varices in patients of cirrhosis as significantly higher and also recommended its use in our clinical practice as part of the diagnostic workup of cirrhotic patients to decrease the financial and sanitary burden of the endoscopy unit as well medical costs related to evs screening.