Interest of Non-Invasive Methods to Predict Esophageal Varices in Cirrhotic Patients in Togo

Abstract

Background: upper digestive endoscopy is the best method for detecting esophageal varices, but its invasiveness and cost make it inaccessible to certain social classes. Aim : to evaluate the performance of non-invasive methods for the presumptive diagnosis of esophageal varices in cirrhotic patients in Togo. Patients and method : this was a cross-sectional descriptive and analytical retrospective data collection conducted over 2 years. It included medical records of cirrhotic patients hospitalized in the Hepato-gastroenterology who undergone transaminase assay, blood count, abdominal ultrasound and an upper GI endoscopy. Results : A total of 114 patients were included, 84 of them were men (sex ratio: 2.8). The mean age of patients was 48±14 years. The most frequent reason for admission was abdominal distension (86%). According to the Child-Pugh classification, cirrhosis was decompensated in 109 patients (95.6%). Esophageal varices were present in 71.1% of patients. At a cutoff value of 110 mm for spleen diameter, the sensitivity for prediction of esophageal esophageal varices was 70.4%, with an area under the ROC curve of 0.63. The areas under the ROC curve for prediction of esophageal varices were 0.27; 0.29; 0.29 respectively for platelet count, platelet/spleen diameter ratio and the [platelets²/spleen diameter] x AST level. A low [platelets²/spleen diameter] x AST level ratio correlated with the presence of esophageal varices at endoscopy. Conclusion : Spleen diameter is a performant non-invasive tool for the prediction of esophageal varices.