Prediction of Oesophageal Varices by Serum Albumin Level among Patients with Cirrhosis of Liver

Background: Oesophageal varix is a common complication of liver cirrhosis. Endoscopy is the gold standard test to detect varices but it is unpleasant for patients. The aim of the study was to determine the predictive value of serum albumin for the prediction of oesophageal varices. Methods: It was a cross-sectional observational study, conducted in gastroenterology department, Dhaka Medical College Hospital, Dhaka on recently diagnosed cirrhotic patients. It was based on routine test for cirrhosis of liver. So, every patient was underwent routine investigations including complete blood count, viral markers, serum albumin, ultra-sonogram of abdomen, upper gastrointestinal endoscopy. Statistical analysis was done using SPSS software version 23. Results: A total number of 150 patients were included. Age of the patient (mean ± SD) was 47.89 ± 14.77 years, while 113 (75.3%) were men. More than half (56.7%) patients had HBV followed by 53(35.3%) was unknown and 12(8.0%) had HCV. Oesophageal varices were observed in 90% of the patients. The mean value of albumin ratio was 2.78 ±0.49 in patients having oesophageal varices and 3.11±0.68 in patients without oesophageal varices which was statistically significant (p<0.05). The correlation of serum albumin with different grades of oesophageal varices was also statistically significant. Considering low serum albumin as below 3.5 gm/dl, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 82.22%, 20.00%, 90.24%, 11.11%, and 76.00% respectively. Conclusion: Serum albumin is a useful noninvasive routine test which can predict the presence of oesophageal varices in cirrhotic patients. It can never replace the gold standard endoscopy test but it can help physicians to predict a high probability of esophageal varices. It may also help for selection of patient who need urgent endoscopy when endoscopy facilities are limited like Covid-19 pandemic situation.