Correlation of Child-Pugh Classification with Esophageal Varices in Patients with Liver Cirrhosis

Abstract

Introduction: The severity of the chronic liver disease can be assessed by several non-invasive methods one of them includes scoring system like Child-Pugh classification.

Aims: The objective of this study was to assess the correlation of Child Pugh class with esophageal varices in patients with liver cirrhosis.

Methods: This was a cross-sectional hospital-based study of 406 patients with liver cirrhosis. Demographic and relevant clinical data were collected using a standardized questionnaire. Abdominal ultrasound, liver function test, full blood count, viral markers were done for all patients. All patients underwent upper gastrointestinal endoscopy to screen for varices and if found were categorized as small and large.

Results: A total of 406 patients with a mean age of 48 ± 11 years were evaluated. There were 72.4% and 27.6% men and women respectively. Variceal screening by upper gastrointestinal endoscopy revealed esophageal varices in 90.1% patients. By Child-Pugh Classification, 60 (14.8%) patients were in class A, 156 (38.4%) in class B and 190 (46.8%) in class C. Among patients with Child class A, 29 (48.3%) had varices. Similarly, 147 (94.2%) and 190 (100%) of Child class B & C had varices respectively. Odds of presence of esophageal varix were 9 times higher for patients with Child-Pugh Classification B and C compared to class A.

Conclusion: Most patients with cirrhosis present late and with advanced stage in this referral center. Most have esophageal varices on their first screening endoscopy. Child-Pugh classification is a reliable measure of stratifying variceal risk in chronic liver disease patients.