Ratio of Platelet Count to Splenic Diameter as a Predictor of Esophageal Varices in Cirrhosis of Liver.

Portal hypertension and oesophageal variceal development are among major complications of cirrhosis. The risk of bleeding from varices is very high. Therefore, periodic endoscopic screening is highly recommended for patients with liver cirrhosis for presence of oesophageal varices. Some studies observed that certain parameters, like splenomegaly and decreased platelet count were associated with the presence of varices and portal hypertension. The aim is to study ratio of platelet count to splenic diameter in patients with cirrhosis of liver and its correlation with presence of oesophageal varices.A hospital based cross sectional observational study was conducted on 114 diagnosed cases of cirrhosis of liver admitted in Navodaya Medical college, Raichur. The inclusion criteria was diagnosed cases of cirrhosis of liver of patient aged 13 years and above. The exclusion criteria were patients with hepatocellular carcinoma, patients with portal vein thrombosis, patients with previous history of abdominal surgery.By applying ROC curve, platelet count to spleen diameter ratio cut off value of 1052 was obtained which give positive and negative predictive values of 97.12% sensitivity and 100% specificity. The study also shows that as the ratio decreases, the grade of the varices increases.This study concludes that presence of oesophageal varices is a common complication in cirrhosis of liver, prevalence is found to be 91.23%. It was observed that as the platelet count to splenic diameter ratio decreases, the grade of varices increases. This ratio may be recommended to predict the presence of oesophageal varices and as a surrogate marker where endoscopic facilities are not available.