Expediency of Platelet (Thrombocyte) count estimate to Spleen diameter ratio as a non-invasive tool in the prediction of Esophageal Varices among Liver Cirrhotic patients.

Objective: To assess the early benefit and usefulness of platelet count to diameter of spleen ratio as a non-invasive parametric tool in detection of esophageal Varices in liver cirrhosis. Study Design: Prospective observational study. Place and Duration: Department of Medicine, Hamdard University Hospital, Karachi from February 06, 2019 to August 31, 2019. Methodology: Among cirrhotic patients, ultrasound technique was employed for platelet count and spleen bipolar ratio. The patients were also screened for esophageal varices. Patients who had active bleeding from upper gastro-intestinal tract were excluded from study. Ratio of Platelet count to diameter of spleen was determined and estimated for all subjects and analyzed. Results: Among 85 liver cirrhotics, 68.2% were male and esophageal varices were found in 63.5% patients. The cut-off value for ratio of platelet count to spleen diameter was 1014 with 76% sensitivity and 67.1% specificity. Among all, 83.33% was estimated by positive predictive value and 80.65% by negative predictive value. The diagnostic accuracy was 82.35%. Conclusion: There is noticeable advantage and usefulness in early detection and advance prediction of esophageal varices in liver cirrhotic subjects by employing non-invasive method of ratio of platelet count to spleen diameter. [ABSTRACT FROM AUTHOR]