Muhammad Khurram, Naveed Yunus Khan, Muhammad Arif, Mian Muhammad Arshad, Hamamatul Bushra Khar, Zubair Hasan, Khushnood Ahmed, Najia Mehmood.
Association of platelet count to splenic index ratio with presence of esophageal varices in patients with hepatitis c virus related compensated cirrhosis.
Pak J Gastroenterol Jan ;20(1):37-42.

Platelet count to splenic index ratio (P/SI) can be used as predictor of presence of esophageal varices in cirrhotic patients. This study was done to note association between P/SI and presence of esophageal varices in hepatitis C virus (HCV) related compensated cirrhotics. 200 adult anti HCV positive cirrhotics diagnosed on clinical features, ultrasound and or liver biopsy were inducted consecutively. In each patient platelet count (by automated analyzer), SI (ultrasonographically) and presence or absence of esophageal varices (endoscopically) were sought. Platelet counts were categorized into normal platelet count (>150,000/mm3) or thrombocytopenic (<150,000/mm3). SI was categorized into 1) 399, 2) 400-599, and 3) 600-699 cm3. P/SI was also subdivided into 1) 0.250, 2) 0.251-0.750, and 3) >0.750. Upper gastrointestinal endoscopy was done in standard way to note presence of esophageal varices. Obtained data was analyzed using statistical program, SPSS version. Chi square test was used as test of significance. Of 200, 53% were male and 47% female. Mean patient age was 43.02±10.83 years. rombocytopenia was noted in 129 (64.50%) patients. SI was <= 399 cm3 in 100 (50%), 400-599 cm3 in 92 (46%), and 600-699 cm3 in 08 (4%) patients. P/SI ratio was 0.250 in 90 (45%), 0.251-0.750 in 82 (41%), and >0.75 in 28 (14%) patients. Esophageal varices were noted in 146 (73%) patients. 121 (94.5%) thrombocytopenic patients had esophageal varices. 48 (48%), 90 (97.8%), and 8 (100%) patients with SI <= 399 cm3, 400-599 cm3, and 600-699 cm3 had varices respectively. 84 (93.3%), 60 (73.1%), and 02 (7%) patients with P/SI s 0.250, 0.251-0.750, and >0.750 had esophageal varices. P/SI s 0.250 was significantly associated with presence of esophageal varices (p-value 0.00, 57.53% sensitivity, and 88.46% specificity). In conclusion thrombocytopenia, splenic index, and P/SI are significantly associated with esophageal varices. P/SI <= 0.250 can be used as marker for presence of esophageal varices.

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