Hubungan Ukuran Besar Varises Esofagus secara Endoskopi dengan "Simpler Score (S Index)" pada Penderita Sirosis Hati

Abstract

Liver cirrhosis is advanced stage of chronic hepatic disease and This condition can lead to multiple complications due to portal hypertension. At the time of diagnosis of liver cirrhosis approximately 600/o of patients with liver cirrhosis have undergone varying degrees of esophageal varices. The aim of this study was to asses the correlation of Simpler Score with esophageal Varices in patient with liver cirrhosis A cross sectional study had been done in 76 cirrhosis patients consists of 57 males and 19 females who underwent treatment in the inpatient unit and policlinic of Gastroenterohepatology division at H. Adam Malik hospital from September 2014 until January 2015. Anamneses , physical examination and laboratory examination were done. Univariate and bivariate analysis ( Independent t test and chi square test ) were done using SPSS version 17 There were significant differences between mean of Simpler score in small esophageal varices and mean of Simpler Score in large esophageal varices (p:0,000). In addition there were significant differences between mean value of platelet, total bilirubin, AST, Albumin, PT, INR, Gamma GT, ALT in small esophageal varices and large esophageal varices (p<0.05). There were no significant differences between mean of age in patient with small esophageal varices and large esophageal varices ( p>0.05). There were significant association between severity of liver cirrhosis, severity of ascites with size of esophageal varices (p<0.05). simpler Score with the cut - off) 0.9558 can identify existing large esophageal varices endoscopically while the value of the cut - off< 0.9558 able to identify the presence of small esophageal varices endoscopically. Predictive value of Simpler score with cut - off > 0.9558 in diagnosing large esophageal varices with sensitivity 80.4o2, specificity 80%, PPV g9.13%, NPV 66.6i/o, and has AUROC 0.876. In conclusion Simpler Score accurate in predicting the size of esophageal varices particularly large varices in patients with liver cirrhosis, so it may be an alternative option of non - invasive method to detect the presence of large esophageal varices