Correlation Between Esophageal Varices and Lok Score as a Non-invasive Parameter in Liver Cirrhosis Patients
Abstract: Bleeding from
gastro-esophageal varices is the most serious and life-threatening complication
of cirrhosis. Endoscopic surveillance of esophageal varices in cirrhotic
patients is expensive and uncomfortable for the patients. Therefore, there is a
particular need for non-invasive predictors for esophageal varices. The aim of
the present study was to evaluate association of esophageal varices and Lok
Score as non-invasive parameter in liver cirrhosis patients.
Method: This is a cross-sectional study of patients admitted at the Adam
Malik hospital Medan between September to December 2014 with a diagnosis of
cirrhosis based on clinical, biochemical, ultrasound, and gastroscopy. Lok
Score was calculated for all patients, tabulated and analyzed.
Results: Among 76 patients with esophageal varices, 55.3% was due to
hepatitis B virus (HBV). The majority of patients were Child C with only 13,2%
being Child Pugh class A. Majority of the population had F2 esophageal varices
(42,1%), F1 (32,9%), and F3 (25%). There is significance difference between Lok
Score and grading of esophageal varices, Lok score is higher in Large
esophageal varices compared with small esophageal varises (0.92 ± 0.14 vs. 0.70
± 0.29; p = 0.001). Lok Score cut-off value of > 0,9141 was highly
predictive in the diagnosis large esophageal varices with a sensitivity of
74.5%, specificity of 72%, positive predictive value of 84%, negative
predictive value 58%, and accuracy was 73.7%.
Conclusion: Lok Score was significantly associated with esophageal
varices. Lok score is a good non-invasive predictor of large esophageal varices
in cirrhotic patients.
Keywords: Lok Score;
non-invasive parameter; esophageal varices
Author: Iqbal Sungkar,
Leonardo Basa Dairi, Gontar Alamsyah Siregar
Journal Code: jpkedokterangg160408
