Correlation between serum ascites albumin gradient and esophageal varices in patients with chronic liver disease

Background Liver cirrhosis is a major source of morbidity and mortality. Esophageal varices and ascites are common complications of portal hypertension. In newly diagnosed cirrhotic patients, endoscopic screening for varices is suggested. This increases the costs and overloads endoscopy units. Aim To study the relationship between serum ascites albumin gradient (SAAG) and presence and severity of esophageal varices in patients with chronic liver disease to validate the use of SAAG as an indirect indication of varices existence. Patients and methods The study was done on 50 adult cirrhotic patients presenting with ascites. Patients were evaluated for laboratory investigations and abdominal ultrasonography. Esophagogastroduodenoscopy was done to find out if varices are present and their severity. Diagnostic paracentesis was done for ascitic fluid examination, and SAAG value was calculated. Based on SAAG value, patients were divided into three groups. Results There was a significant difference in the distribution of varices between SAAG groups. At cutoff value of SAAG of greater than equal to 1.5, the occurrence of varices can be predicted with 76% accuracy, sensitivity of 77%, and specificity of 75%. Conclusions There is a directly proportional significant relation between SAAG value and the presence of esophageal varices, as well as their severity. A cutoff value of SAAG of greater than equal to 1.5 can be used for prediction of varices existence. Accordingly, SAAG could be used to predict the development of varices among other noninvasive predictors.