Abstract
UTILIZATION OF PLATELET COUNT/SPLEEN DIAMETER RATIO IN PREDICTING THE PRESENCE OF ESOPHAGEAL VARICES IN FILIPINO PATIENTS WITH CIRRHOSIS
M.F.N De Leon, MD; M.A.V. Chu, MD;L.B. Gatchalian, MD; M.Talingdan-Te, MD; S.D. Preza-Carmona, MD
Section of Gastroenterology, Department of Internal Medicine , East Avenue Medical Center, East Avenue, Diliman, Quezon City, Philippines
Significance: Upper endoscopy is the gold standard for screening of esophageal varices. However, in developing countries such as the Philippines, not all patients have access to this procedure. This study will provide validation of Platelet Count/Spleen Diameter ratio as an alternative to upper endoscopy in screening for esophageal varices in Filipino patients with liver cirrhosis.
Methodology: We performed a single-center, prospective, cross sectional study in 88 adult patients with liver cirrhosis at East Avenue Medical Center from June 2022 to November 2022. Complete biochemical workup, upper endoscopy, and abdominal ultrasonography were done. Platelet count/spleen diameter ratio was calculated for all patients. Sensitivity, specificity, positive predictive value and negative predictive value of PC/SD ratio were determined.
Results: Seventy-eight (78) of the patients have esophageal varices in EGD. Alcoholic liver disease was the most common etiology in both study groups (30.77%, with varices; 40%, without varices). Majority of patients with esophageal varices were CTP B (46.15%). A PC/SD ratio of <909 has sensitivity and specificity of 42.30% and 90.0%, respectively. Positive predictive value is at 97.05% and negative predictive value is 16.60%. In conclusion, PC/SD ratio of <909 may be used as an alternative noninvasive test to diagnose esophageal varices in cirrhotic patients who have no access to EGD. However, PC/SD ratio > 909 cannot substitute for upper gastrointestinal endoscopy in ruling out the presence of esophageal varices.
Keywords: Cross-sectional study; Platelet count/spleen diameter ratio; Esophageal varices; Hepatic cirrhosis; Filipino patients
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |