DIAGNOSTIC ACCURACY OF PLATELET COUNT/SPLEEN DIAMETER RATIO FOR ESOPHAGEAL VARICES IN PATIENTS WITH HEPATIC CIRRHOSIS

Abstract

Objective
To evaluate the diagnostic accuracy of the platelet count/spleen diameter (PC/SD) ratio in predicting esophageal varices among patients with liver cirrhosis, taking endoscopy as the gold standard.

Methodology
This cross-sectional study was conducted at the Department of Medicine, Combined Military Hospital, Multan, over six months following approval from CPSP and the hospital ethics committee. A total of 286 cirrhotic patients aged 30–75 years were included through non-probability consecutive sampling. Patients with hepatocellular carcinoma, prior variceal bleeding, or prophylactic therapy were excluded. Platelet counts were determined using an automated hematology analyzer, and spleen diameter was measured via ultrasound. All patients underwent upper GI endoscopy for confirmation of esophageal varices. Data were analyzed using SPSS version 23, and diagnostic accuracy parameters were calculated using a 2×2 contingency table.

Results
The mean age was 53.9 ± 10.1 years; 62.6% were male. The mean platelet count was 112.5 ± 41.8 ×10⁹/L, spleen diameter 150.7 ± 23.9 mm, and PC/SD ratio 747.2 ± 352.6. Esophageal varices were found in 229 (80.1%) patients on endoscopy and predicted in 237 (82.9%) by PC/SD ratio. The sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of the PC/SD ratio were 83.8%, 70.2%, 91.9%, 51.9%, and 81.1%, respectively.

Conclusion
The PC/SD ratio is a reliable, non-invasive predictor of esophageal varices in cirrhotic patients, reducing the need for routine endoscopy—especially valuable in resource-limited settings