Abstract
Background: One of the major causes of morbidity
and mortality in Nepal is portal hypertension due
to liver cirrhosis. In rural areas where a lot of cases
of cirrhosis of liver are prevalent and endoscopic
expertise and facilities are not available, predicting
the presence of esophageal varices through
noninvasive means may reduce a large number of
unnecessary endoscopies. This study is to identify
the relationship of platelet count /splenic bipolar
diameter ratio with the presence of esophageal varices
in portal hypertension.
Materials and methods: Eighty patients were included in this study
between Jestha 2072 to Baisakh 2073 with the
diagnosis of portal hypertension admitted in Bir
hospital,Kathmandu which is a tertiary hospital of
government of Nepal, which were mostly due to
liver cirrhosis. The patients fulfilling the inclusion
criteria underwent lab investigations, ultra sonogram
and UGI endoscopy. The data were assessed for
descriptive studies and means were compared using
t- test. The cut off value of platelet count to spleen
diameter ratio of 1150 was used to predict the
presence or absence of oesophageal varices. Statistical
analysis was done using SPSS 20 software
Results: Platelet count to splenic diameter ratio with a
cut off value of 1150 has sensitivity of 89.7%,
specificity of 83.3%, positive predictive value of
96.8% and negative predictive value of 58.8% (p=
0.002,CI=95%) with 89.5 % accuracy.
Conclusion: Platelet count to splenic bipolar diameter ratio
can be a good predictor of presence of esophageal
varices in patients with portal hypertension
in the resource poor settings.
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