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LOW SPECIFICITY OF PLATELET TO SPLEEN RATIO FOR NONINVASIVE PREDICTION AND CHARACTERIZATION OF ESOPHAGEAL VARICES IN PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS

IVICA GRGUREVIĆ orcid.org/0000-0003-0520-3483 ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Dubrava, Klinika za unutarnje bolesti,Zavod za gastroenterologiju, Sveučilište u Zagrebu, Farmaceutsko- biokemijski fakultet, Zagreb, Hrvatska
IVANA JUKIĆ ; Sveučilište u Zagrebu, Farmaceutsko- biokemijski fakultet, Zagreb, Hrvatska
SANDA SOKOL ; Sveučilište u Zagrebu,Medicinski fakultet, Klinička bolnica Dubrava, Klinika za unutarnje bolesti, Zagreb, Hrvatska
MARKO BANIĆ ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Dubrava, Klinika za unutarnje bolesti,Zavod za gastroenterologiju,Zagreb, Sveučilište u Rijeci,Medicinski fakultet, Katedra za internu medicinu, Rijeka, Hrvatska
BRANKO BILIĆ ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Dubrava, Klinika za unutarnje bolesti,Zavod za gastroenterologiju,Zagreb, Hrvatska
IVAN GUNJAČA ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Dubrava, Klinika za unutarnje bolesti,Zavod za gastroenterologiju,Zagreb, Hrvatska
MILAN KUJUNDŽIĆ ; Sveučilište u Zagrebu, Medicinski fakultet, Klinička bolnica Dubrava, Klinika za unutarnje bolesti,Zavod za gastroenterologiju, Sveučilište u Zagrebu, Farmaceutsko- biokemijski fakultet, Zagreb, Hrvatska
MIA RORA ; Sveučilište u Zagrebu, Medicinski fakultet,Katedra za internu medicinu, Zagreb, Hrvatska
VLATKO MATIĆ ; Sveučilište u Zagrebu, Medicinski fakultet,Katedra za internu medicinu, Zagreb, Hrvatska

Sažetak

Diagnosis of esophageal varices (EV) is based upon endoscopic examination, which is a rather unpleasant method that carries a
certain risk of complications. For that reason, efforts have been made to develop noninvasive methods for characterization of EV. The aim of this study was to explore the value of platelet count to spleen size ratio (PSR) for noninvasive prediction and characterization of EV in patients with alcoholic liver cirrhosis (ALC). One hundred and seventeen patients (20 females and 97 males, mean age 60.7) with ALC were included in our research. All patients underwent endoscopic examination upon which the EV were classifi ed as small (<5 mm), large (>5 mm), or absent. Spleen size (bipolar diameter in mm) was assessed by ultrasound. Platelet count to spleen diameter ratio was calculated and the values obtained were compared to the presence, size and risk of bleeding from EV as defi ned by endoscopy. No signifi cant difference in PSR could be found between patients without and with EV (1.341±0.725 vs. 1.053±0.636, respectively; p=0.06). The PSR was signifi cantly different between the patients with small and large EV (1.103±0.689 vs. 0.876±0.314; p<0.05) with a cut-off value of 1.141 (sensitivity 94.7%, specifi city 38.2%, AUROC=0.656; p=0.042). The value of PSR below 1.182 pointed to patients at risk from variceal bleeding with 91.7% sensitivity and 38.5% specifi city (AUROC =0.625, p=0.035). Based on our results, it is not possible to recommend the use of PSR as the exclusive noninvasive indicator for the presence, size and bleeding risk from EV due to its low specificity for these categories in patients with ALC.

Ključne riječi

liver cirrhosis; portal hypertension; esophageal varices; platelet count; ultrasonography

Hrčak ID:

142197

URI

https://hrcak.srce.hr/142197

Datum izdavanja:

22.7.2015.

Podaci na drugim jezicima: hrvatski

Posjeta: 1.859 *