The Role of Aspartate Aminotransferase to Platelet Ratio Index as a Non-Invasive Predictor of Variceal Etiology of Upper Gastrointestinal Bleeding

Authors

  • Ashish Shrestha Dhulikhel Hospital Kathmandu University Hospital, Nepal https://orcid.org/0000-0002-6065-5119
  • Pasanda Sharma Dhulikhel Hospital Kathmandu University Hospital, Nepal
  • Anjila Lama Dhulikhel Hospital Kathmandu University Hospital, Nepal
  • Ram Bahadur Gurung Dhulikhel Hospital Kathmandu University Hospital, Nepal

Keywords:

Aspartate aminotransferase, Gastrointestinal bleeding, Platelets, Variceal bleeding

Abstract

Introduction: Non-invasive strategies to predict variceal from non-variceal bleeding will be highly beneficial for pre-emptive management of Upper Gastrointestinal Bleeding (UGIB). This study aimed to assess the role of aspartate aminotransferase (AST) to platelet ratio index (APRI) as a non-invasive predictor of variceal etiology of UGIB.

Methods: This was a retrospective descriptive study conducted at Endoscopy Department of Dhulikhel Hospital between January 2017 and December 2019 in patients presenting with acute UGIB. We assessed the diagnostic utility of the APRI score relative to other objective measures by Area Under the Receiver Operating Characteristic (AUROC) curve analysis.

Results: A total of 158 patients with history of UGIB were included in the study. There were total 123 males (77.8%) and the mean age of the patients was 50.3±16.1 years. The APRI score performed well in predicting a variceal etiology of acute UGIB, with AUROC 0.9. When APRI was used at cut-off of 1.3, it had a sensitivity of 84.1% and specificity of 76.8%, a positive predictive value of 70.7% and a negative predictive value of 89.9% while predicting variceal etiology of UGIB at presentation. The relative risk of varices at an APRI cut-off of 1.3 is 17.5 with a p-value of <0.0001.

Conclusion: The present study highlighted that APRI score can be used as an objective metric that helps to predict a variceal etiology of acute UGIB.

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Author Biographies

Ashish Shrestha, Dhulikhel Hospital Kathmandu University Hospital, Nepal

Lecturer, Department of Internal Medicine

Pasanda Sharma, Dhulikhel Hospital Kathmandu University Hospital, Nepal

Lecturer, Department of Internal Medicine

Anjila Lama, Dhulikhel Hospital Kathmandu University Hospital, Nepal

BSc Nurse, Department of Internal Medicine

Ram Bahadur Gurung, Dhulikhel Hospital Kathmandu University Hospital, Nepal

Associate Professor, Department of Internal Medicine

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Published

2020-09-20

How to Cite

Shrestha, A., Sharma, P., Lama, A., & Gurung, R. B. (2020). The Role of Aspartate Aminotransferase to Platelet Ratio Index as a Non-Invasive Predictor of Variceal Etiology of Upper Gastrointestinal Bleeding. Journal of Lumbini Medical College, 8(2), 206–211. Retrieved from https://nepjol.info/index.php/JLMC/article/view/40817

Issue

Vol. 8 No. 2 (2020)

Section

Original Research Articles

License

Copyright (c) 2020 Ashish Shrestha, Pasanda Sharma, Anjila Lama, Ram Bahadur Gurung

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