Resumo

INFANTE VELAZQUEZ, Mirtha et al. Factors predicting the presence of esophageal varices in cirrhotic patients. Rev Cub Med Mil [online]. 2013, vol.42, n.1, pp. 56-61. ISSN 0138-6557.

Introduction: although endoscopy is the method of choice to identify the presence of esophageal varices in cirrhotic patients, in absence of endoscopes, it is possible to infer them by predictive factors. Objective: to identify clinical, biochemical and ultrasonographic parameter related to the presence of esophageal varices. Methods: an analytical and multicenter study was conducted. Inclusion and exclusion criteria were defined. Measurement were applied for clinical, haematological, and biochemical parameters, as well as for the severity of cirrhosis according to Child-Pugs. Abdominal ultrasound to measure bipolar spleen diameter and endoscopy for varices were used. Univariate and multivariate analysis were carried out. Results: we studied 102 patients, they were mostly male (55/102, 53.9 %), this group had a mean age 55.76 ± 12.6 years. 65.7 % of cases (n = 67) had esophageal varices. Relationship was shown with the presence of ascites, varices (p = 0.002), low albumin values (p = 0.030), platelet count (p = 0.001), spleen size (p = 0.001) and the count ratio platelets/bipolar diameter spleen (p = 0.001). In multivariate analysis, only the aforementioned ratio resulted to be an independent predictive factor (OR: 0.993, 95 % CI: 0.991-0.996). Conclusions: the significance of clinical and laboratory parameters was confirmed to predict the presence of esophageal varices, which can be used for the management of patients with cirrhosis in the absence of the possibility of endoscopy for diagnosis.

Palavras-chave : esophageal varices; endoscopy; cirrhosis.

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