usefulness of noninvasive predictors of oesophageal varices in black african cirrhotic patients in côte d'ivoire (west africa)

usefulness of noninvasive predictors of oesophageal varices in black african cirrhotic patients in côte d'ivoire (west africa)

;Alassan Kouamé Mahassadi;Fulgence Yao Bathaix;Constant Assi;Aboubacar Demba Bangoura;Emile Allah-Kouadio;Henriette Ya Kissi;Abdoulaye Touré;Stanislas Doffou;Issa Konaté;Alain Koffi Attia;Mathieu Benoit Camara;Thérèse Aya Ndri-Yoman
colloids and surfaces a: physicochemical and engineering aspects 2012 Vol. 2012 pp. -
98
mahassadi2012gastroenterologyusefulness

Abstract

Aims. To determine the usefulness of platelet count (PC), spleen diameter (SD) and platelet count/spleen diameter ratio (PC/SD ratio) for the prediction of oesophageal varices (OV) and large OV in black African patients with cirrhosis in Côte d’Ivoire. Materials and Methods. Study was conducted in a training sample (111 patients) and in a validation sample (91 patients). Results. Factors predicting OV were sex: (OR=0.08, P=0.0003), PC (OR = 12.4, P=0.0003), SD (OR = 1.04, P=0.002) in the training sample. The AUROCs (±SE) of the model (cutoff ≥ 0.6), PC (cutoff < 110500), SD (cutoff > 140) and PC/SD ratio (cutoff ≤ 868) were, respectively; 0.879 ± 0.04, 0.768 ± 0.06, 0.679 ± 0.06, 0.793 ± 0.06. For the prediction of large OV, the model’s AUROC (0.850 ± 0.05) was superior to that of PC (0.688 ± 0.06), SD (0.732 ± 0.05) and PC/SD ratio (0.752 ± 0.06). In the validation sample, with PC, PC/SD ratio and the model, upper digestive endoscopy could be obviated respectively in 45.1, 45.1, and 44% of cirrhotic patients. Prophylactic treatment with beta blockers could be started undoubtedly respectively in 36.3, 41.8 and 28.6% of them as having large OV. Conclusion. Non-invasive means could be used to monitor cirrhotic patients and consider treatment in African regions lacking endoscopic facilities.

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