International Journal For Multidisciplinary Research

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Predictive Value Of Platelet Count To Spleen Diameter Ratio For Oesophageal Varices

Author(s) Dr. Pratima Goyal, Dr. M.S Chaudhary, Dr. Sanjay Sikka, Dr. Vijay Singh Rawat, Dr. Shiva Narang
Country India
Abstract BACKGROUND AND AIM- Oesophageal variceal bleeding is a frequently occurring complication in patients with end stage liver disease and cirrhosis with very high mortality rates. The diagnosis and management of oesophageal varices is dependent on repeated upper gastrointestinal endoscopy which is invasive in nature. However, it presents a problem in terms of non-compliance by patients and its invasive nature. Hence, in this study we explored the use of “ratio of platelet count to spleen diameter” to predict oesophageal varices in patients with cirrhosis as it is a non-invasive parameter and would result in better compliance. Although such a parameter cannot negate the importance of upper gastrointestinal endoscopies but may be used as an adjuvant to ascertain adequate interval for monitoring thereby ensuring optimal utilization of resources.
METHODS: This study was conducted in a tertiary care hospital in Delhi between August 2018 to 2019 and we computed the ratio of platelet count to spleen diameter in all patients to predict oesophageal varices in cirrhotic patients. It was carried out on 81 patients. The diagnosis of liver cirrhosis was made on the basis of clinical evidence of decompensation or varices and/or radiological evidence of nodularity of liver and collaterals and/or fibroscan values suggestive of cirrhosis. Platelet count was recorded and spleen diameter was measured and the ratio was then calculated. In order to confirm oesophageal varices in all these patients, an upper gastrointestinal endoscopy was done as a standard test.
RESULTS: Results showed predominance of male participants at 72.8% (n=59). Overall, the incidence of oesophageal varices was 69.1%. In 38.3% participants, alcoholic liver disease was the cause of cirrhosis. The cut off ratio of ≤975 was present in 65.4% patients and a total 69.1% patients had varices on endoscopy. Thus, the ratio of <975 showed good accuracy in picking up the presence of oesophageal varices which was confirmed on endoscopy. The sensitivity (94.6%), specificity (84%), positive predictive value (93%) and negative predictive value (87.5%) of the ratio were found to be high in predicting oesophageal varices with high Area under the curve (0.96, 95%CI=0.93-0.99).
CONCLUSION: The platelet count to spleen diameter ratio of 975 had high sensitivity (94.6%) and specificity (84%) as well as good positive and negative predictive values of 93% and 87.5 % respectively for predicting oesophageal varices. Based on our study results, the ratio was found to be a good marker to predict the probability of having oesophageal varices among end stage liver disease patients and can help in categorising high risk patients and thereby prevent unnecessary invasive endoscopies in low risk individuals.
Keywords platelet count, spleen diameter, oesophageal varices
Field Medical / Pharmacy
Published In Volume 8, Issue 1, January-February 2026
Published On 2026-02-04
DOI https://doi.org/10.36948/ijfmr.2026.v08i01.67921
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