The value of serum-ascites albumin gradient for predicting esophageal-gastric fundus variceal bleeding / 中华消化杂志

ABSTRACT

Objective To screen the risk factors of esophageal-gastric fundus variceal bleeding,in order to provide a more economical and less invasive method for predicting esophageal-gastric fundus variceat bleeding. Methods A total of 168 diagnosed liver cirrhosis patients accompanied with ascites and 60 cases of liver cirrhosis patients with primary hepatic carcinoma were enrolled. Followed up for one year, the esophageal-gastric fundus variceal bleeding was observed and analyzed with statistic methods. Results Unconditional single factor logistic regression model analysis indicated that albumin level of ascites, serum-ascites albumin gradients (SAAG), platelets, activated partial thromboplastin time (APTT), portal vein width, length and thickness of the spleen were independent risk factors,age and serum albumin were protective factors. Multifactor analysis indicated SAAG, APTT, and portal vein width were the independent risk factors, OR was 3.559 , 2.468 and 2. 608 respectively.After building receiver operating characteristic curve, the best SAAG cut-off value was 18.50 g/L, of which the sensitivity was 96.3％ and specificity was 56.3％. Conclusion SAAG has good value in predicting esophageal-gastric fundus variceal bleeding.