Child Pugh Score as a Predictor of Large Oesophageal Varices in Chronic Liver Disease Patients

  • Awasthi Girish Mahakali Hospital, Kanchanpur, Nepal
  • Tirtha Man Shrestha Department of General Practice, Tribhuwan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Keywords: chronic liver disease, esophageal varices, non- endoscopic predictors


Introduction: Variceal hemorrhage is a major complication of chronic liver disease. If patients at low or high risk of having esophageal varices (EV) could be identified by the Child Pugh score in predicting the size of oesophageal varices in patients with chronic liver disease. The main objective of this study was to determine whether Child Pugh Score can be used as a predictor of large oesphageal varices in chronic liver disease patient.

Methods: A prospective cross-sectional study was conducted in emergency and medicine ward of Tribhuvan University Teaching Hospital from August 2015 to December 2015 with diagnosed chronic liver disease without history of previous medication for varices and any surgical intervention were studied. Patients underwent physical examination, hematological and biochemical tests and abdominal sonography and upper gastrointestinal endoscopy. Presence and absence of esophageal varices size was noted and correlation with Child Pugh Score and it’s associated variables studied.

Results: Alcoholic liver disease was the major cause for chronic liver disease with most common age group involved being 41-50 years and 72% prevalence of esophageal varices. A statistically significant association was found between oesophageal varices grade and Child-Pugh’s classification grades i.e., the higher grade of oesophageal varices is associated with advanced grade of Child’s classification.

Conclusions: Child Pugh Score had a predictive value to diagnose esophageal varices in chronic liver disease patients. The predictive accuracy as compared to the gold standard test “UGI endoscopy” showed that these parameters cannot replace endoscopy as the diagnostic test but can be used as a screening tool especially in a country like Nepal where availability of endoscopy facilities and access to tertiary care hospitals is an issue.