Aspartate Aminotransferase to-Platelet Ratio Index; a reliable Non-Invasive Marker for Liver Cirrhosis – two year case control study at limited resources set up

Background:

Cirrhosis has now emerged as an important public health problem globally and is currently the leading cause of death among liver-related diseases. Aspartate Aminotransferase to-platelet ratio index, a newer prognostic modality has been demonstrated to be a very effective non-invasive diagnostic for identifying advanced liver fibrosis by several studies. In this study, we looked at the efficacy of Aspartate Aminotransferase to-platelet ratio index as a non-invasive prognostic marker for liver cirrhosis in patients attending a tertiary care centre in India.

Methods:

In this case control analytical study 100 cases of individuals with cirrhosis and 100 controls over a period of 2 years were enrolled. Aspartate Aminotransferase to-platelet ratio index was calculated along with all the clinical characteristics, as well as biochemical charcacteristics including  liver function tests, kidney function tests, prothrombin time, and examination findings including Ultrasonography.

Results:

Our study results showed that 48% of the study participants belonged to the age groups of 40-60 years. We also observed a statistically significant difference between the study groups with respect to the distribution of APRI. (p-value <0.001). On comparing the validity of APRI scores in detecting cirrhosis, the area under the ROC curve for APRI in detecting cirrhosis was 0.693, and the ideal APRI cut-off value was 3.99, with sensitivity, specificity, PPV, and NPV of 33%, 86%, 70%, and 56%, respectively.

Conclusion:

Thus, our study results conclude that APRI is an important non-invasive prognostic tool that can be utilised for prognostication of liver cirrhosis.