Diagnostic value of noninvasive markers in the formation and severity of esophageal varices in cirrhotic patients

Abstract

The aim of this study is to evaluation of diagnostic value of noninvasive markers in the formation and severity of esophageal varices in cirrhotic patients. Materials and Methods: This study was cross-sectional study and the target population included all cirrhotic patients admitted to the gastrointestinal ward (or with a history of hospitalization in this ward) and all cirrhotic patients referred to the gastrointestinal clinic of Imam Reza Hospital in 2020. The sample size in this study was 126 people. In this study, individuals were divided into two groups: cirrhotic patients with esophageal varices and cirrhotic patients without esophageal varices (which was determined according to the gold standard, ie endoscopy performed in these patients). The sampling method in this study was available. By examining non-invasive markers obtained from patients' blood samples (INR, PT, PTT, Platelet and Albumin) as well as the presence or absence, size and severity of esophageal varices through endoscopy, the relationship between these two issues was assessed. These examinations were performed through information that already exists in the patients' files with a history of hospitalization. Results: In this study, the mean (standard deviation) of age in the two groups of cirrhotic patients with esophageal varices and cirrhotic patients without esophageal varices were 60.50 (±13.7) and 57.25 (±12.8) years, respectively. Among cirrhotic patients with esophageal varices, 8 cases (26.6%) were grade 1, 11 cases (36.7%) were grade 2 and 11 cases (36.7%) were grade 3. None of the variables of age and gender were statistically significant difference between the two groups of cirrhotic patients with esophageal varices and cirrhotic patients without esophageal varices (P-value> 0.05). Also, among blood factors, the only variable of PLT in the group of cirrhotic patients without esophageal varices was significantly higher than the group of cirrhotic patients with esophageal varices (P-value = 0.020). Among the blood factors in predicting the formation of esophageal varices in cirrhotic patients, only the PLT variable significantly had the power to predict the formation of esophageal varices (P-value = 0.006). The optimal cut-off point of PLT variable in predicting the formation of esophageal varices in cirrhotic patients was 84500.0, which sensitivity and specificity at this cut-off point was 59% and 60%, respectively, and the Yuden index was 0.19; On the other hand, among the blood factors in predicting the severity of esophageal varices in cirrhotic patients, none of the variables PT, PTT, INR, PLT and Albumin significantly had the power to predict the severity of esophageal varices (P-value> 0.05).