THE PLATELET COUNT AS A PREDICTOR OF VARICEAL HEMORRHAGE IN PRIMARY BILIARY-CIRRHOSIS

Background: Variceal bleeding is a common, life-threatening complicati on of primary biliary cirrhosis (PBC) that remains difficult to predic t. Objective: The aim of this study was to identify whether certain bi ochemical and hematological parameters may be used as predictors of va riceal bleeding in patients with PBC. Methods: Cox proportional hazard regression analysis was used to test whether various prognostic facto rs were significantly associated with the time of first bleeding in 63 patients with proven PBC, of whom 11 had subsequent bleeding. Results : Both the first available platelet count and the bilirubin level were of significant value in predicting variceal bleeding, but only the pl atelet count was an independent predictor of bleeding. In the group of patients who subsequently bled, there was a progressive drop in the p latelet count over the follow-up period, with a proportional increase in the risk of bleeding; a platelet count below 200 x 10(9)/L was stro ngly associated with variceal bleeding (p < 0.001). None of the patien ts with platelet count above 200 x 10(9)/L bled over a total of 136 pa tient-years follow-up. In the group who did not bleed, no change in pl atelet count was identified during follow up. Conclusion: We conclude that the platelet count can be used as a predictor of variceal bleedin g in PBC.