Significance of non-invasive markers as predictor of esophageal varices in liver cirrhosis

Dipendra Khadka; Sushil Prajapati; Sudhamshu KC; Jeetendra Kaji Shrestha; Niyanta Karki; Bikash Jaishi; Kiran Regmi; Sandip Khadka

Article:
Significance of non-invasive markers as predictor of esophageal varices in liver cirrhosis

creativeworkseries.issn	JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
dc.contributor.author	Dipendra Khadka
dc.contributor.author	Sushil Prajapati
dc.contributor.author	Sudhamshu KC
dc.contributor.author	Jeetendra Kaji Shrestha
dc.contributor.author	Niyanta Karki
dc.contributor.author	Bikash Jaishi
dc.contributor.author	Kiran Regmi
dc.contributor.author	Sandip Khadka
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.creator.affiliation	Liver Unit, Department of Medicine, NAMS, Bir Hospital, Kathmandu, Nepal.
dc.date.accessioned	2026-09-17T09:11:50Z
dc.date.available	2026-09-17T09:11:50Z
dc.date.issued	2017
dc.description.abstract	Abstract Introduction: Upper gastro-intestinal endoscopy remains the gold standard for screening for esophageal varices but it has its own limitations. It is an invasive, expensive and uncomfortable procedure and needs clinical expertise. Accordingly, this study was conducted to establish the role of non-invasive markers for prediction of esophageal varices in liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function test, liver ultrasound and upper gastro-intestinal endoscopy were done for all patients to detect esophageal varices and to correlate with different non-invasive markers. Results: Total 191 patients of liver cirrhosis were studied after exclusion. Platelet count of 92082.00Â±43435.83/mm3 and spleen size of 144.21Â±10.71 mm was found to be good predictors of presence of EV (Pâ‰¤0.001). Significant association between Child-Turcotte-Pugh class and presence of varices was observed (Pâ‰¤0.001). AST/ALT ratio with cutoff value of 1.415 showed sensitivity of 82.4% and specificity of 36.4%. APRI at a cutoff value of 1.3 showed a sensitivity of 83.2% and specificity of 50%. Conclusions: Platelet count, spleen size and Child-Turcotte-Pugh class are good predictors of presence of esophageal varices in patients with liver cirrhosis. AST/ALT ratio and APRI score are not good substitutes for upper gastro-intestinal endoscopy. Keywords: Esophageal varices; Liver cirrhosis; Non-invasive markers; Portal hypertension; Upper gastro-intestinal.
dc.identifier.doi	https://doi.org/10.31729/jnma.3379
dc.identifier.uri	https://hdl.handle.net/20.500.14572/7734
dc.language.iso	en_US
dc.publisher	Nepal Medical Association
dc.subject	Esophageal varices
dc.subject	Liver cirrhosis
dc.subject	Non-invasive markers
dc.subject	Portal hypertension
dc.subject	Upper gastro-intestinal.
dc.title	Significance of non-invasive markers as predictor of esophageal varices in liver cirrhosis
dc.type	Article
dspace.entity.type	Publication
local.article.type	Original Article
oaire.citation.endPage	416
oaire.citation.startPage	412
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relation.isJournalIssueOfPublication.latestForDiscovery	879289ff-bc63-435d-b0e3-5f2202d261ef
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