title: Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis.
abstract: OBJECTIVE
  To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.
  
  
  METHODS
  This was an analytical cross-sectional study to validate the diagnostic test for hepatic cirrhosis and was performed between February 2010 and December 2011. Patients with a diagnosis of hepatic cirrhosis were included and stratified using their Child-Pugh score. Biochemical parameters were evaluated, and ultrasound was used to measure the longest diameter of the spleen. The platelet count/spleen diameter ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices. Upper gastrointestinal endoscopy was used as the gold standard. Sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were determined, with the cutoff points determined by receiver-operating characteristic curves.
  
  
  RESULTS
  A total of 91 patients were included. The mean age was 53.75 ± 12 years; 50 (54.9%) were men, and 41 (45.0%) women. The etiology of cirrhosis included alcohol in 48 (52.7%), virally induced in 24 (26.3%), alcoholism plus hepatitis C virus in three (3.2%), cryptogenic in nine (9.8%), and primary biliary cirrhosis in seven (7.6%). Esophageal varices were present in 73 (80.2%) patients. Child-Pugh classification, 17 (18.6%) patients were classified as class A, 37 (40.6%) as class B, and 37 (40.6%) as class C. The platelet count/spleen diameter ratio to detect esophageal varices independent of the grade showed using a cutoff value of ≤ 884.3, had 84% sensitivity, 70% specificity, and positive and negative predictive values of 94% and 40%, respectively.
  
  
  CONCLUSIONS
  Our results suggest that the platelet count/spleen diameter ratio may be a useful tool for detecting esophageal varices in patients with hepatic cirrhosis.
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Gabino
authors.initials: G
authors.lastname: Cervantes-Guevara
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Manuela
authors.initials: M
authors.lastname: Chávez-Sánchez
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Dávalos-Cobián
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Susana
authors.initials: S
authors.lastname: Ornelas-Cázares
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Michel Dassaejv
authors.initials: MD
authors.lastname: Macías-Amezcua
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Mariana
authors.initials: M
authors.lastname: Chávez-Tostado
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Kenia Militzi
authors.initials: KM
authors.lastname: Ramírez-Campos
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Anaís Del Rocío
authors.initials: Adel R
authors.lastname: Ramírez-Arce
authors.affiliation: Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fuentes-Orozco
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001792:Blood Platelets / Q000166:cytology*; D003430:Cross-Sectional Studies; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications* / Q000208:ethnology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
keywords: Esophageal varices; Hepatic cirrhosis; Hepatitis C virus; Mexican patients; Platelet count/spleen diameter ratio