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31 Jan 2023 (Vol 46 , Iss 02 )

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31 Jan 2023 (Vol 46 , Iss 01 )

Journal ID : TMJ-14-06-2022-11313
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Title : The Prevalence and Clinical Predictors of Esophageal Varices in Liver Cirrhosis Patients at Dr. Cipto Mangunkusumo National Referral Hospital in Indonesia

Abstract :

Liver cirrhosis is a terminal condition which can cause a complication in the form of esophageal varices (EV). Early detection and management of EV had become an important factor to prevent the occurrence of bleeding. This study is aimed to explore the prevalence and clinical predictors of EV. A cross-sectional study on liver cirrhosis patients undergoing EV screening using endoscopy in the Hepatobiliary Integrated Procedure Room of Dr. Cipto Mangunkusumo Hospital (RSCM) was conducted from January 2016 to December 2017. From a total of 148 patients, the prevalence of EV in patients with liver cirrhosis was 57.4%, which was categorized into small degree (23.6%) and large degree (33.8%). This study also found a significant mean difference in clinical parameters between the EV and non-EV groups. These parameters include albumin and bilirubin levels, INR, and platelet count, as well as CTP, MELD, and APRI scores (p<0.001). The clinical parameter with the highest discrimination and sensitivity in predicting EV was CTP score (AUROC: 0.734, 77.65% sensitivity, 61.90% specificity, p<0.001) while the APRI score was found to have the highest specificity (AUROC: 0.691, 60.00% sensitivity, 71.43% specificity, p<0.001). Patients with CTP-C score were found to be the highest proportion of cirrhosis patients experiencing EV. Parameters such as platelet count and CTP scores could act as clinical predictors of EV in cirrhosis patients.

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