Esophageal Variceal Grading and Platelet Count in Patients With Liver Cirrhosis

Abstract

BACKGROUND Esophageal varices represent a critical consequence of liver cirrhosis, with the risk of hemorrhage closely associated with the grade of the varices. Upper gastrointestinal endoscopy (UGIE) is the definitive method for detection; nonetheless, it is invasive and resource-demanding. Recognizing straightforward, non-invasive indicators like platelet count may assist in risk stratification and prioritize endoscopic screening in patients with cirrhosis. OBJECTIVE This study aimed to ascertain the correlation between esophageal variceal grading and platelet count in individuals with liver cirrhosis and to assess the clinical relevance of thrombocytopenia as a predictor of high-grade varices. MATERIALS AND METHODS This observational, descriptive study was performed from August 2022 to August 2023. One hundred twenty cirrhotic individuals had a UGIE assessment for esophageal varices. Demographic, clinical, and laboratory data, including platelet counts, were documented. Patients were classified according to platelet count (>150, 100-150, and <100×10⁹/L) and variceal grades (I-III). The correlation between platelet count and variceal grade was evaluated utilizing chi-squared tests, odds ratios (OR), and multivariate logistic regression in IBM SPSS Statistics for Windows, V. 27.0 (IBM Corp., Armonk, NY, USA). RESULTS A notable adverse correlation was identified between platelet count and the severity of esophageal varices. Patients exhibiting reduced platelet counts were more predisposed to high-grade (Grade III) varices, with thrombocytopenia <100×10⁹/L serving as an independent predictor of high-grade varices, even after controlling for confounding variables. The Child-Turcotte-Pugh Class C was correlated with high-grade varices, although age and ascites were not significant predictors. CONCLUSION Thrombocytopenia is markedly correlated with advanced stages of esophageal varices and may function as an effective, non-invasive indicator for detecting high-risk cirrhotic patients. Integrating platelet count into clinical decision-making may enhance risk classification and refine endoscopic screening strategies in resource-constrained environments.