Abstract :
Background & Aim: Correlations between serum ascites albumin gradient (SAAG) and presence of esophageal varices (EV), prevalence of EV, variceal size, incidence of esophageal variceal bleeding (EVB) and mortality were compared between the group of cirrhotic patients with SAAG <1.5 g/dL and the group with SAAG ≥1.5 g/dL. The predictive value of SAAG with regard to the presence of EV and variceal complications was also determined.
Methods: This prospective cohort study was conducted in cirrhotic patients with portal- type ascites with EV. Variceal size and incidence of EVB were recorded and compared between two groups. All patients were followed up to the study end-point, which was occurrence of EVB, or death or intolerance to the treatment prescribed.
Results: Thirty-five patients were enrolled, 4 patients with SAAG <1.5 g/dL and 31 patients with SAAG ≥1.5 g/dL. The prevalence and the size of EV were higher and larger in the SAAG ≥1.5 g/dL group. The sensitivity and specificity of SAAG >1.65 for predicting the presence of EV were 96.4% and 71.4%, while those of SAAG >2.05 for predicting the presence of large EV were 87.5% and 66.7%, respectively. The prevalence of EVB was also higher in the SAAG ≥1.5 g/dL group than SAAG <1.5 g/dL group, with no statistically significant difference.
Conclusion: The SAAG appeared useful in predicting the presence of EV and EVB. The higher value of SAAG was associated with a higher prevalence of large EV. The incidence of EVB was also higher in patients with higher SAAG. However, there is no statistically significant difference due to the relatively small sample size.
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file/Thai-Journal-of-gastroenterology-vol-12-no-1-2678367.pdf