Key result
Elevated spleen stiffness predicts esophageal varices with 94% sensitivity and correlates with bleeding risk.
Why the study?
Noninvasive tests for predicting esophageal varices in cirrhosis have shown varying sensitivity and specificity, and the utility of spleen stiffness measurement needed investigation.
Does spleen stiffness measurement accurately predict the presence of esophageal varices in patients with cirrhosis compared to other noninvasive tests?
Population
200 consecutive cirrhotic patients with 174 valid stiffness measurements
Comparison
Spleen stiffness vs liver stiffness, LSPS, and PSR for predicting esophageal varices
Design
Cross-sectional study using transient elastography and endoscopy
Authors
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Spleen stiffness may support noninvasive esophageal varices screening; leaves open prospective validation before changing endoscopic practice.
Cross-Sectional (n=200)
Does spleen stiffness measurement accurately predict the presence of esophageal varices in patients with cirrhosis compared to other noninvasive tests?
Effect estimate: 94% sensitivity, 76% specificity, 86% diagnostic accuracy
p-value: p=0.001
Spleen stiffness measured by transient elastography is a highly accurate noninvasive method for predicting the presence and size of esophageal varices in patients with cirrhosis.
Sharma et al. (2013) conducted a cross-sectional in Cirrhosis (n=200). Spleen stiffness measurement vs. Liver stiffness, LSPS, and PSR was evaluated on Prediction of esophageal varices (94% sensitivity, 76% specificity, 86% diagnostic accuracy, p=0.001). Spleen stiffness ≥40.8 kPa predicted esophageal varices with 94% sensitivity, 76% specificity, and 86% diagnostic accuracy, and was significantly higher in patients with large varices or bleeding.
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