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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 216390, 10 pages
http://dx.doi.org/10.1155/2012/216390
Clinical Study

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

1Service d’Hépato-Gastroentérologie, CHU de Yopougon, 21 BP 632 Abidjan 21, Cote d'Ivoire
2Service d’Hépato-Gastroentérologie, CHU de Cocody, Abidjan, Cote d'Ivoire
3Service d’Imagérie Médicale, CHU de Yopougon, Abidjan, Cote d'Ivoire
4Service d’Imagérie Médicale, CHU de Cocody, Abidjan, Cote d'Ivoire

Received 14 January 2012; Revised 17 May 2012; Accepted 25 May 2012

Academic Editor: Fabio Farinati

Copyright © 2012 Alassan Kouamé Mahassadi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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: ( O R = 0 . 0 8 , 𝑃 = 0 . 0 0 0 3 ), PC (OR = 12.4, 𝑃 = 0 . 0 0 0 3 ), SD (OR = 1.04, 𝑃 = 0 . 0 0 2 ) 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.