Platelet count/spleen diameter ratio for non-invasive diagnosis of oesophageal varices: is it useful in compensated cirrhosis?
OBJECTIVE
To assess the diagnostic accuracy of the platelet count/spleen diameter ratio for identification of oesophageal varices and/or hypertensive gastropathy in patients with compensated cirrhosis.


METHODS
Platelet count/spleen diameter ratio was calculated in 87 consecutive patients with compensated cirrhosis. A new cut-off with the highest sensitivity and specificity for the presence/absence of oesophageal varices and/or hypertensive gastropathy was identified. Performance of the platelet count/spleen diameter ratio considering previously reported cut-off values were then tested in our population.


RESULTS
A platelet count/spleen diameter ratio <936.4 had the best sensitivity and specificity for the diagnosis of oesophageal varices and for all endoscopic findings of portal hypertension. A value lower than 936.4 allowed identification of 64.5% of patients with oesophageal varices and 66.7% of patients with any sign of portal hypertension; a value higher than 936.4 excluded oesophageal varices in 64.3% of patients and any sign of portal hypertension in 68.6% of patients.


CONCLUSIONS
In patients with compensated cirrhosis, the platelet count/spleen diameter ratio is not a useful parameter to avoid unnecessary upper endoscopy, independently of the cut-off.
Gastroenterology and Hepatology Unit, San Filippo Neri Hospital, Rome, Italy. manuelamangone@virgilio.it
Manuela
M
Mangone
Alessandra
A
Moretti
Federica
F
Alivernini
Claudio
C
Papi
Ruggero
R
Orefice
Angelo
A
Dezi
Emanuela
E
Amadei
Annalisa
A
Aratari
Marco
M
Bianchi
Valentina
V
Tornatore
Maurizio
M
Koch
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D004945:Esophagoscopy; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010976:Platelet Count; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D013154:Spleen / Q000473:pathology*