Thomopoulos et al identified clinical findings associated with esophageal varices in a patient with cirrhosis. These can help identify those patients who need endoscopic evaluation and those who do not. The authors are from the University Hospital of Patras and the Democritus University of Thrace in Greece.
Patient selection: presence of cirrhosis
Parameters:
(1) platelet count
(2) ascites
(3) length of the spleen in mm
Parameter
Finding
Points
platelet count
>= 118,000 per µL
0
< 118,000 per µL
1
ascites
absent
0
present
1
length of the spleen in mm
< 135 mm
0
>= 135 mm
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum risk score: 0
• maximum risk score: 3
• The risk of significant esophageal varices increases with a higher score.
• Patients with 0 risk factors have a 13% chance of varices, all of which are small.
• Patients with 3 risk factors have an 83% chance of varices with 28% having large varices.
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