Usefulness of Noninvasive Predictors of Oesophageal Varices in Black African Cirrhotic Patients in Côte d'Ivoire (West Africa)

• Main Authors: 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
• Format: Article
• Language: English
• Published: Hindawi Limited 2012-01-01
• Series: Gastroenterology Research and Practice
• Online Access: http://dx.doi.org/10.1155/2012/216390

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.