Comparative Evaluation of Non-invasive Predictors of Oesophageal Varices in Cirrhosis: Platelet Count, Spleen Diameter, and Platelet-to-Spleen Diameter Ratio.
- 1General Medicine, Mahadevappa Rampure Medical College, Kalaburagi, IND.
- 2Internal Medicine, Mahadevappa Rampure Medical College, Kalaburagi, IND.
Abstract
Background Oesophageal varices are a common complication of portal hypertension in cirrhosis, and upper gastrointestinal endoscopy remains the standard method for their detection and grading. The platelet count-to-spleen diameter (PC/SD) ratio is a simple non-invasive parameter that may help identify patients at increased risk of oesophageal varices. Methods This prospective observational study included 80 patients with cirrhosis and portal hypertension who were evaluated at Basaveshwar Teaching and General Hospital, Kalaburagi, Karnataka, between February 20, 2024, and August 20, 2025. PC, SD measured by ultrasonography, and the PC/SD ratio were assessed. All participants underwent upper gastrointestinal endoscopy for detection and grading of oesophageal varices. The association between PC/SD ratio and variceal presence and grade was evaluated, and receiver operating characteristic (ROC) curve analysis was performed. Results Oesophageal varices were present in 42 (52.5%) patients, while 38 (47.5%) had no varices. Endoscopic grading showed Grade 1 varices in four (5.0%), Grade 2 in six (7.5%), and Grade 3 in 32 (40.0%) patients. The mean PC/SD ratio was significantly lower in patients with varices than in those without varices (809.51 ± 405.64 vs. 2,209.19 ± 1,479.72, p < 0.001). The mean PC/SD ratio progressively decreased with increasing variceal grade, from 2,209.19 in Grade 0 to 707.61 in Grade 3 (F = 11.887, p < 0.001). ROC analysis demonstrated an area under the curve of 0.893 (95% CI, 0.818-0.969; p < 0.001). A PC/SD ratio cut-off of <926 yielded a sensitivity of 89.5% and specificity of 69.0%. Conclusion The PC/SD ratio was significantly associated with the presence and severity of oesophageal varices in patients with cirrhosis and portal hypertension. It may serve as a simple adjunctive screening and risk-stratification tool to help prioritise patients for endoscopic evaluation. Larger multicentre studies are required to validate the study-specific cut-off and its broader clinical applicability.
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BibTeX
@article{dhotre2026comparative,
title = {{Comparative Evaluation of Non-invasive Predictors of Oesophageal Varices in Cirrhosis: Platelet Count, Spleen Diameter, and Platelet-to-Spleen Diameter Ratio.}},
author = {Basamma Dhotre and Suresh Harsoor},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117358},
url = {https://europepmc.org/article/MED/42968979},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Evaluation of Non-invasive Predictors of Oesophageal Varices in Cirrhosis: Platelet Count, Spleen Diameter, and Platelet-to-Spleen Diameter Ratio.
AU - Basamma Dhotre
AU - Suresh Harsoor
PY - 2026
DA - 2026/10/02
JO - Cureus
DO - 10.7759/cureus.117358
UR - https://europepmc.org/article/MED/42968979
AB - Background Oesophageal varices are a common complication of portal hypertension in cirrhosis, and upper gastrointestinal endoscopy remains the standard method for their detection and grading. The platelet count-to-spleen diameter (PC/SD) ratio is a simple non-invasive parameter that may help identify patients at increased risk of oesophageal varices. Methods This prospective observational study included 80 patients with cirrhosis and portal hypertension who were evaluated at Basaveshwar Teaching and General Hospital, Kalaburagi, Karnataka, between February 20, 2024, and August 20, 2025. PC, SD measured by ultrasonography, and the PC/SD ratio were assessed. All participants underwent upper gastrointestinal endoscopy for detection and grading of oesophageal varices. The association between PC/SD ratio and variceal presence and grade was evaluated, and receiver operating characteristic (ROC) curve analysis was performed. Results Oesophageal varices were present in 42 (52.5%) patients, while 38 (47.5%) had no varices. Endoscopic grading showed Grade 1 varices in four (5.0%), Grade 2 in six (7.5%), and Grade 3 in 32 (40.0%) patients. The mean PC/SD ratio was significantly lower in patients with varices than in those without varices (809.51 ± 405.64 vs. 2,209.19 ± 1,479.72, p < 0.001). The mean PC/SD ratio progressively decreased with increasing variceal grade, from 2,209.19 in Grade 0 to 707.61 in Grade 3 (F = 11.887, p < 0.001). ROC analysis demonstrated an area under the curve of 0.893 (95% CI, 0.818-0.969; p < 0.001). A PC/SD ratio cut-off of <926 yielded a sensitivity of 89.5% and specificity of 69.0%. Conclusion The PC/SD ratio was significantly associated with the presence and severity of oesophageal varices in patients with cirrhosis and portal hypertension. It may serve as a simple adjunctive screening and risk-stratification tool to help prioritise patients for endoscopic evaluation. Larger multicentre studies are required to validate the study-specific cut-off and its broader clinical applicability.
SN - 2168-8184
ER -