Siddharth Gosavi1, Samarth Sangamesh2, Amogh Ananda Rao3, Shashank Shastry4, Aishwarya Hulikal5, Ayushi Mendiratta6
BACKGROUND
Chronic liver disease is the progressive destruction of liver for 6 months thereby
impairing clotting factor formation, bile metabolism, and protein synthesis. Child-
Pugh-Turcotte (CTP) score, model for end-stage liver disease (MELD) and MELD–
sodium (Na) are well established calculated parameters to predict prognosis in
chronic liver disease (CLD) patients. This study was conducted to determine as to
how aspartate aminotransferase : platelet ratio index (APRI) fares in predicting
adverse outcomes and prognosis among patients with chronic liver disease
compared to other liver scoring.
METHODS
This was a cross-sectional hospital-based study of inpatients admitted in the
department of General Medicine at Chigateri General Hospital. MELD, MELD-Na,
Child-Pugh-Turcotte score, and APRI index, were applied and calculated on all the
50 patients to stage the chronic liver disease, and were followed up for 3 months.
RESULTS
19 patients survived and 31 patients died. Among the 31 dead patients, 24 had
MELD score of greater than 21.5 points. Sensitivity of MELD & MELD-Na in
predicting mortality was 77.42 %. Diagnostic accuracy for both scores was 74 %.
All patients who died had a Child Pugh score of greater than 10. The sensitivity of
CTP scoring was 100 % and diagnostic accuracy was 98 %. 76 % of our patients
experienced severe fibrosis according to APRI index. 4 % experienced significant
fibrosis. 20 % of the patients did not have significant fibrosis. The least sensitivity
(61.29 %) and diagnostic accuracy (62 %) was observed with APRI. However,
positive predictive value was 73.08 % and diagnostic accuracy was 65 % for
mortality.
CONCLUSIONS
Given the minimal investigations required in calculating APRI, it can be used as a
fair indicator predicting status of the patient especially in resource limited settings.
