title: Evaluation of Aspartate Aminotransferase-to-Platelet Ratio Index as a Non-Invasive Marker for Liver Cirrhosis.
abstract: BACKGROUND
  Liver biopsy is considered as a gold standard for the diagnosis of cirrhosis. Till date there is no non-invasive marker to replace it.
  
  
  OBJECTIVE
  To investigate the effectiveness of Aspartate aminotransferase-to-platelet ratio index (APRI) as a non-invasive marker for liver cirrhosis.
  
  
  METHODS
  Fifty-one patients with cirrhosis, identified on USG abdomen were included in study. Platelet count and Aspartate aminotransferase (AST) were done using haematology automatic analyser and automatic HITACHI-912 Auto Analyser respectively. APRI was calculated for every patient using the formula {(AST / ULN) x 100}/platelet count (10(9)/L). Predictive accuracy was evaluated with a receiver-operating characteristics (ROC) curve.
  
  
  RESULTS
  APRI correctly classified 49 (96.1%) patients of cirrhosis with area under the ROC curve of 0.973 (95% CI) at cut-off 0.65 with negative predictive value (NPV) and Positive predictive value (PPV) of 96% and 96.1% respectively. The sensitivity and specificity of the test was found to be 96% and 96.1% respectively.
  
  
  CONCLUSIONS
  APRI could identify cirrhosis with high degree of accuracy in the studied patients.
authors.affiliation: Ex Resident, Department of Medicine, VMMC & SJH , New Delhi, India .
authors.forename: Princi
authors.initials: P
authors.lastname: Jain
authors.affiliation: Professor, Department of Medicine, VMMC & SJH , New Delhi, India .
authors.forename: B K
authors.initials: BK
authors.lastname: Tripathi
authors.affiliation: Ex Professor and Head, Department of Medicine, VMMC & SJH , New Delhi, India .
authors.forename: B
authors.initials: B
authors.lastname: Gupta
authors.affiliation: Assistant Professor, Department of Physiology, AIIMS , Jodhpur, India .
authors.forename: Bharti
authors.initials: B
authors.lastname: Bhandari
authors.affiliation: Assistant Professor, Department of Orthopaedics, AIIMS , Jodhpur, India .
authors.forename: Divesh
authors.initials: D
authors.lastname: Jalan
keywords: Cirrhosis; Liver enzymes; Platelet count