scholarly journals Significance of Non-Invasive Markers as Predictor of Esophageal Varices in Liver Cirrhosis

2017 ◽  
Vol 56 (208) ◽  
pp. 412-6 ◽  
Author(s):  
Dipendra Khadka ◽  
Sushil Prajapati ◽  
Sudhamshu KC ◽  
Jeetendra Kaji Shrestha ◽  
Niyanta Karki ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Clinical Expertise ◽  
Spleen Size ◽  
Cross Sectional ◽  
Cutoff Value ◽  
Non Invasive ◽  
Pugh Class

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 92082.00±43435.83/mm3 and spleen size of 144.21±10.71 mm was found to be good predictors of presence of EV (P≤0.001). Significant association between Child-Turcotte-Pugh class and presence of varices was observed (P≤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.

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with 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 tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

scholarly journals Diagnostic Accuracy of Non-invasive Laboratory-Based Fibrosis Scores in Predicting the Presence of Esophageal Varices in Liver Cirrhosis

2020 ◽  
Vol 9 (2) ◽  
pp. 54-59
Author(s):  
Rajesh Pandey ◽  
Rahul Pathak ◽  
Arun Gnawali ◽  
Prem Krishna Khadga ◽  
Sashi Sharma ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic ◽  
Esophageal Varices ◽  
Operating Characteristic ◽  
Cutoff Value ◽  
Non Invasive ◽  
Apri Score ◽  
Receiver Operating

Introduction: Non-invasive assessment of esophageal varices (EVs) may reduce endoscopic burden and cost. This study aimed to evaluate the diagnostic accuracy of non-invasive fibrosis scores (AAR, APRI, FIB-4, King and Lok scores) for the prediction of varices in liver cirrhosis. Methods: This prospective study included 100 liver cirrhosis patients who underwent screening endoscopy for EVs. AAR, APRI, FIB-4, King and Lok scores were assessed. The receiver operating characteristic curves (ROC) were plotted to measure and compare the performance of each score for predicting EVs and to obtain the corresponding optimal prediction value. Results: Of the 100 patients, 70 were males and 30 were females with a mean age of 54.05±11.58 years. Esophageal varices were found in 77 patients out of which 58.44% were high-risk varices. Platelet count and non-invasive fibrosis scores APRI, FIB-4, Lok and King were able to discriminate patients with and without varices. Using area under receiver operating characteristic curve (AUROC), these scores were found to have low to moderate diagnostic accuracy for the presence of EVs and high-risk EVs, where the APRI score had the highest AUROC (0.77 and 0.70) respectively. At a cutoff value > 1.4, APRI score had 90.9% sensitivity, 60.9% specificity and 84 % diagnostic accuracy in predicting the presence of varices, while it had 84.4% sensitivity, 45.5% specificity and 63% diagnostic accuracy in predicting the presence of highrisk varices, at a cutoff value > 2.02. Conclusion: APRI, AAR, FIB-4, King, and Lok scores had low to moderate diagnostic accuracy in predicting the presence of varices in liver cirrhosis. The APRI score can help select a patient for the endoscopy but cannot replace endoscopy for esophageal varices screening.

scholarly journals Non-Endoscopic Parameters for Predicton of Esophageal Varices

2017 ◽  
Vol 6 (2) ◽  
pp. 21-26
Author(s):  
Rahul Pathak ◽  
Roshan Jha ◽  
Prem Khadga ◽  
Shashi Sharma
Keyword(s):  
Platelet Count ◽  
Diagnostic Accuracy ◽  
Esophageal Varices ◽  
Rural Areas ◽  
Financial Burden ◽  
Tertiary Care ◽  
Diameter Ratio ◽  
Spleen Size ◽  
Non Invasive ◽  
Screening Endoscopy

Introduction: Non invasive assessment of esophageal varices may improve the management and lower the medical and financial burden related to the screening. In this study, Our aim was to validate the prediction of varices using platelet count/spleen diameter ratio and Alanine transaminase/platelet ratio index (APRI).Methods: Fifty patients with newly diagnosed and treatment naive cirrhosis underwent screening endoscopy along with hematological and ultrsonographic studies. Platelet count/spleen diameter ratio and APRI index were assessed and their diagnostic accuracy calculated. Based on previous studies, a cutoff of 909 was applied for platelet count/spleen diameter ratio and cutoff of > 1.3 for APRI. The diagnostic accuracy of both the indices were further evaluated for severity and size of varices.Results: Prevalence of varices was 36% out of which 24% were large varices. Platelet count/spleen size diameter, portal vein diameter and APRI index had significant association for prediction of presence of varices and strongly correlated with size of varices. Platelet count/spleen size diameter of 909 had diagnostic accuracy of 80.5% for prediction of varices with diagnostic accuracy being 95.8 for predicting large varices. APRI index of more than 1.3 had accuracy of 75% for predicting varices and 87.5% for accurately predicting them as large varices.Conclusions: In a resource limited country like ours, where access to specialized and tertiary care hospitals and availability of endoscopy facilities in rural areas is an issue, these non invasive parameters platelet count/spleen diameter and APRI can be taken as a safe and reliable predictor for esophageal varices.Journal of Advances in Internal Medicine 2017;06(02):21-26.

PLATELET COUNT AND SPLEEN DIAMETER RATIO FOR NON INVASIVE DIAGNOSIS OF ESOPHAGEAL VARICES

2021 ◽  
pp. 14-18
Author(s):  
Pooja Krishnappa ◽  
Vasant PK ◽  
Subhash Chandra
Keyword(s):  
Platelet Count ◽  
Roc Curve ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Meld Score ◽  
Diameter Ratio ◽  
P Value ◽  
Cutoff Value ◽  
Non Invasive

BACKGROUND: Portal Hypertension and its consequences mainly, Esophageal Varies (EVs) is one of the most important causes of morbidity and mortality in patients with cirrhosis of liver. Upper GI endoscopy is the investigation of choice for diagnosis of EVs and periodic endoscopies have been recommended for monitoring of varices. There is a need for non-invasive parameters to detect the presence of EVs. Identication of noninvasive predictors of EVs will help us to carry out EGD in selected groups of patients. Unnecessary endoscopies can be avoided and at the same time, patients who require endoscopy can be referred to a higher center, where facilities for endoscopy are available. Among the non-invasive modalities, the platelet count and bipolar spleen diameter ratio has shown promising results in terms of its accuracy in predicting the presence of Esophageal Varices in many studies MATERIALS AND METHODS: Patients with chronic liver disease diagnosed using clinical, Laboratory and ultrasound parameters were assessed using esophagogastroduodenoscopy for the presence or absence of esophageal varices. USG abdomen was done to assess for bipolar splenic diameter and the presence or absence of EV's was correlated with the platelet count/ splenic diameter ratio, CHILD SCORE, MELD score, Platelet count alone and splenic diameter alone. Platelet count/SD ratio of 909 based on previous studies was correlated with the presence or absence of varices. Statistical analysis was done using IBM SPSS software version 20.0 and variables showing statistically signicant correlations with presence of arices were used for plotting ROC curves to assess the cut of points which could be used for non invasive prediction of varices. RESULTS: The PC/SD ratio cut off (909), based on previous studies for non invasive diagnosis of Esophageal Varices gave sensitivity and specicity of 97.9% and 91.7% respectively, in our study, which was statistically signicant (P value <0.001). The positive predicitive value and negative predictive value of the PC/SD ratio (909) was 96.5% and 94.8% respectively and the accuracy of the test was 96%. ROC curve for Platelet count and Splenic diameter ratio area under the curve is 97.8% with P value < 0.001 and cutoff value 895.02 with sensitivity 96.6% and specicity 96.5%. The Positive predictive value and negative predictive value of PC/SD ratio of 895 was found to be 98.6% and 91.8% respectively and the accuracy of the test 96.5%. ROC curve for Child score in our study, area under the curve 71% with a signicant P value < 0.001, and cut-off value obtained for Child score was 8.50 with sensitivity 64.8% and specicity 63.8 %. ROC curve for MELD score revealed area under the curve was 74.3% with P value as < 0.001, and the cut-off value was 15.5 with sensitivity 67.6 % and specicity 67.2%. ROC curve for Platelet count in our study, the area under the curve was 94.5% with P value as < 0.001, and the cut-off value was 108500 with sensitivity and specicity of 89.7% and 89.4% respectively. The ROC curve for Spleen diameter in our study revealed that the area under the curve was 86.8%% with P value as < 0.001, and the cutoff value was 121 with sensitivity and specicity of 78.9% and 81.0% respectively. CONCLUSION: Among the variables studied for non-invasive diagnosis of Esophageal varices, the Platelet count / Spleen diameter ratio had the best sensitivity and specicity for diagnosing EVs. In view of low sensitivities and specicities for the cut off values obtained for Child score, MELD score, platelet count and spleen diameter, these indices may not be useful as PC/SD ratio in the non-invasive prediction of EV's. The Platelet count / Splenic diameter ratio may be proposed as a safe parameter for diagnosing Esophageal Varices in Chronic Liver disease noninvasively, where resources are limited and endoscopy facilities are not available, to select the patients with probable Esophageal Varices who can be referred to higher centres

scholarly journals Correlation between Platelet Count vs Spleen Bipolar Diameter Ratio and Esophageal Varices in Liver Cirrhosis

2018 ◽  
Vol 8 (2) ◽  
pp. 159-166
Author(s):  
Md Mahfuzzaman ◽  
Md Nazmul Hoque ◽  
Shireen Ahmed ◽  
Tareq Mahmud Bhuiyan
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Diameter Ratio ◽  
Noninvasive Methods ◽  
Endoscopic Screening ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Cirrhosis Of Liver

Background: Esophageal variceal bleeding is a potentially fatal complication in patients with liver cirrhosis and portal hypertension. In cirrhotic patients, endoscopic screening for esophageal varices (EV)is currently recommended at the time of diagnosis. The present study intends to find out correlation between platelet countspleen bipolar diameter ratio and esophageal varices in liver cirrhosis and prospectively validate its use for the noninvasive diagnosis of EV.Methods: This observational study was done at theDepartment of Gastrointestinal Hepatobiliary and Pancreatic Disorder, BIRDEM General Hospital, Dhaka, during the period of November, 2013 to October, 2014. A total 64 patients with cirrhosis of liver were included. Complete blood count, liver function tests, ultrasonographyof whole abdomenand endoscopy of upper gastro-intestinal tract (GIT)were done in all patients. Statistical analysis was done with SPSS version 16.Results: Among 64 study population EV were detected in 54 patients (84.4%). The platelet count/ spleen bipolar diameter ratio was significantly higher without EV compared with those with EV(1570 ± 493) and (688 ± 227), respectively; (p<0.001).Patients with EV had lower platelet counts (86799.84 ±27389.99/mm3, p<0.001), higher bipolar spleen diameters (127.94±15.14 mm, p<0.001) and lower platelet count/ spleen bipolar diameter ratios (688.79 ±227.13, p<0.001). In this analysis, by applying (ROC)curve the platelet count-spleen bipolar diameter ratio at a cut-of 908.5 maintained high sensitivity (100 %), Robust negative predictive value NPV (100%),specificity (55.6%) and PPV (85.4%), with an overall diagnostic accuracy of 87.50% for the prediction of EV.With advancing Child-Pugh (C-P) class the percentage of patients with varices increased, 33.3% in C-P class A, 85.7% in C-P class B and 91.6% in C-P class C. The presence of EVcorrelated significantly with the severity of liver cirrhosis (p = 0.03) as measured by Child-Pugh score.Conclusion: The identification of non-endoscopic, noninvasive methods that can accurately predict esophageal varicesin cirrhosis of liver has been addressed in several recent studies. This study was yet another attempt to achieve this goal. Predicting the presence of EV by noninvasive means would restrict the performance of endoscopy and reducing the number of unpleasant screening endoscopiesBirdem Med J 2018; 8(2): 159-166

scholarly journals Role of Ultrasonography in Predicting Gastro-oesophageal Varices in Patients with Liver Cirrhosis

2021 ◽  
Vol 17 (1) ◽  
pp. 10-15
Author(s):  
Merina Gyawali ◽  
Ramesh Raj Acharya
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal System ◽  
Oesophageal Varices ◽  
Spleen Size ◽  
Cross Sectional ◽  
Non Invasive ◽  
The Social ◽  
Vein Diameter ◽  
Splenic Size

IntroductionUpper Gastrointestinal endoscopy is considered the best screening tool in detecting gastroesophagealvarices in patients with cirrhosis. Ultrasonography of the abdomen can be used forassessment of liver and portal system. This research was undertaken to demonstrate that theportal vein diameter and splenic size by ultrasonography can be used as a non-invasive predictorof gastro-esophageal varices. MethodsA cross-sectional hospital based study comprising of 290 consecutive patients with liver cirrhosiswere enrolled between November 2019 to November 2020. Clinical profile at admission andsonological splenic size and portal vein diameter were studied in all cirrhotic patients. Patientswere classified into 2 groups: one with presence of varices and second without varices. Data entrywas done in Statistical Packages for the Social Sciences version 20. ResultsThe mean age of subjects was 52±13.26 years with a range of 27 – 82 years of age (M:F=2:1). Thecommonest etiology of cirrhosis was chronic alcohol consumption. The prevalence of varices incirrhotics was 42.8%. Average portal vein diameter of patients without gastro-esophageal variceswas 11.12 ± 1.36 mm, while it was 12.81 ± 1.62 mm in patients with varices (p < 0.001). Averagespleen size in cirrhotics without varices was 12.44 ± 1.32 cm and with varices was 14.32 ± 2.42 cm.This difference was also statistically significant (p < 0.001). ConclusionsMeasurement of portal vein diameter and spleen size by ultrasonography can be recommendedas a non invasive predictor for gastro-oesophageal varices in patients with liver cirrhosis . Keywords: cirrhosis; portal vein diameter; spleen size; ultrasonography; gastro-oesophageal varices

scholarly journals PLATELET COUNT SQUARED/SPLEEN DIAMETER-ASPARTATE AMINOTRANSFERASE RATIO: NON-INVASIVE METHOD TO PREDICT ESOPHAGEAL VARICES

2017 ◽  
Vol 54 (3) ◽  
pp. 222-224 ◽  
Author(s):  
Ângelo Zambam de MATTOS ◽  
Larissa Faraco DAROS ◽  
Angelo Alves de MATTOS
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

ABSTRACT BACKGROUND - Variceal bleeding has a high mortality among cirrhotics, and screening with endoscopy is indicated at the diagnosis of cirrhosis. Screening with endoscopy implies discomfort, risks and considerable costs. OBJECTIVE - To evaluate platelet count squared/spleen diameter-aspartate aminotransferase ratio (PS/SA), as a non-invasive predictor of esophageal varices in cirrhotics. METHODS - This cross-sectional study evaluated cirrhotics for PS/SA and presence of esophageal varices. Outpatient records of cirrhotic patients were reviewed for the abovementioned data. Sensitivity, specificity, negative and positive predictive values of PS/SA were calculated. After the univariate analysis, variables with P<0.10 were submitted to a logistic regression. RESULTS - The study included 164 cirrhotics, 59.70% male, with a mean age of 56.7 years. Hepatitis C was the most frequent cause of cirrhosis, being present in 90 patients. Patients were classified as Child-Pugh A in 52.44% and as Child-Pugh B or C in 47.56%. Esophageal varices were present in 72.56% of the patients at endoscopy. PS/SA, with a cutoff of 3x108, had a sensitivity of 95.80% (confidence interval of 95% - 95%CI=0.92-0.99), a specificity of 22.70% (95%CI=0.10-0.35), a positive predictive value of 77.20% (95%CI=0.70-0.84) and a negative predictive value of 66.70% (95%CI=0.42-0.91). In the logistic regression, only platelet count and Child-Pugh score were associated to esophageal varices (P<0.05). CONCLUSION - PS/SA has an excellent sensitivity to predict esophageal varices, allowing almost one fourth of patients without esophageal varices to spare endoscopy. Nevertheless, PS/SA is not independently associated to esophageal varices.

scholarly journals Gambaran Kadar Trombosit, Besar Limpa dan Kadar Albumin Serum pada Pasien Sirosis Hati dengan Varises Esofagus

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Vella Paraditha ◽  
Saptino Miro ◽  
Eti Yerizel
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Albumin Level ◽  
Spleen Size ◽  
Medical Record Data ◽  
Cirrhosis Patient ◽  
Liver Cirrhosis Patient ◽  
Physical Laboratory ◽  
Record Data

Gambaran Kadar Trombosit, Besar Limpa dan Kadar AlbuminSerum pada Pasien Sirosis Hati dengan Varises EsofagusVella Paraditha1, Saptino Miro2, Eti Yerizel3AbstrakVarises esofagus merupakan komplikasi sirosis hati yang didiagnosis dengan endoskopi. Pada keadaantertentu, pemeriksaan endoskopi tidak dapat dilaksanakan, sehingga diperlukan cara lain sebagai alternatif untukmenilai varises esofagus. Tujuan penelitian ini adalah mengetahui gambaran kadar trombosit, besar limpa dan kadaralbumin serum pasien sirosis hati pada berbagai derajat varises esofagus. Penelitian ini berupa deskriptif retrospektifdengan instrumen data rekam medik pasien sirosis hati dengan varises esofagus yang telah menjalani pemeriksaanfisik, laboratorium dan endoskopi di RSUP dr. M. Djamil Padang dari Januari 2010 sampai Juli 2012. Sampel yangdidapatkan berjumlah 33 pasien. Sebagian besar pasien mengalami trombositopenia. Penurunan kadar trombosit tidakberhubungan dengan peningkatan derajat varises esofagus. Besar limpa pada sebagian besar pasien dengan varisesesofagus derajat 1, 2, maupun 3 adalah ≤ S1. Seluruh pasien mengalami hipoalbuminemia. Penurunan kadar albuminserum tidak berhubungan dengan peningkatan derajat varises esofagus. Penelitian ini menunjukkan bahwa penurunankadar trombosit dan kadar albumin serum tidak berhubungan dengan peningkatan derajat varises esofagus. Tidakterdapat perbedaan besar limpa yang signifikan antara pasien dengan varises esofagus derajat 1, 2, maupun 3.Direkomendasikan agar menggunakan jumlah sampel yang lebih banyak pada penelitian selanjutnya dan data yangdigunakan sebaiknya diperoleh dari pemeriksa yang sama.Kata kunci: kadar trombosit, besar limpa, kadar albumin, derajat varises esofagusAbstractEsophageal varices is a complication in liver cirrhosis which can be diagnosed by endoscopy. However, oncertain conditions, endoscopy examination can not be performed. Another method is needed as an alternative toassess the esophageal varices. The objective of this study was to recognize platelet count, spleen size and serumalbumin level of liver cirrhosis patient in each esophageal varices degree. This is a retrospective descriptive study. Theinstruments used in this study are the medical record data of liver cirrhosis patients that have esophageal varices, whohave undergone physical, laboratory and endoscopy examinations in dr. M. Djamil Hospital Padang on January 2010-July 2012. Thirty-three patients were eligible for this study. The most of patients had thrombocytopenia. The decreasein platelet count was not related to the increase in esophageal varices degree. Spleen size in most of patients with first,second, and third degree esophageal varices was ≤ S1. All of patients had hypoalbuminemia. The decrease in albuminlevel was not related to the increase in esophageal varices degree. This study showed that the decrease in plateletcount and albumin level were not related to the increase in esophageal varices degree. There was no significantdifference in spleen size between patients with first, second, or third degree esophageal varices.Keywords: platelet count, spleen size, albumin level, esophageal varices degree

scholarly journals Are non invasive predictors of esophageal varices reliable?

2019 ◽  
Vol 7 (2) ◽  
pp. 508
Author(s):  
Akshatha Savith ◽  
Sidhartha Naidu Bhumireddy
Keyword(s):  
Platelet Count ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Non Invasive ◽  
Vein Diameter ◽  
One Year

Background: One of the most serious complications of portal hypertension is the development of esophageal varices and variceal bleeding due to the rupture of varices. The purpose of the study was to assess the efficacy of various clinical and laboratory parameters in predicting the presence and severity of esophageal varices in cirrhotic patients.Methods: This is an observational cross-sectional study done in the department of medicine in Vydehi Institute of Medical Sciences, Bengaluru over a period of one year. Total of 76 patients above the age of 18years with the diagnosis of cirrhosis of any etiology were included. Multivariate Backward method was applied and Portal vein diameter, Platelet count, PT INR, FIB-4 score, APRI, AST/ALT ratio were included as predictors in the model.Results: No statistically significant correlation was found between platelet count, portal vein diameter, FIB 4 score, APRI, AST/ALT ratio and presence of esophageal varices.Conclusions: Present study showed that the non invasive markers such as platelet count, portal vein diameter, FIB 4 score, APRI and AST/ALT ratio are not reliable in predicting the presence of esophageal varices.

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