Liver Cirrhosis Investigation Using Abdominal Ultrasound as Gold Standard Test and Some Bioclinical Markers with Different Levels of Diagnostic Accuracy in Chronic Liver Disease Patients between 1990 and 2004 at Teaching Hospital of Kinshasa, Democratic Republic of the Congo
Liver cirrhosis (LC) is an ultimate phase of chronic liver disease. The infor-mation from the abdominal ultrasound (aUS) is one of complementary biological and clinical tests of LC assessment in the lack of liver biopsy. The aim of this study was to compare levels of diagnostic accuracy of some bio-clinical markers for LC detection using an abdominal ultrasound as a surrogate Gold standard. This was a mixed approach of consecutive patients treated for gut diseases between 1990 and 2004 at Lomo Center. LC diagnosed by aUS and confirmed by histopathology was compared to LC diagnosed by Bioclinical tests under ROC, Chi-Square, and Logistics regression (for accuracy diagnosis, Sensitivity, Specificity, AUC, and kappa) at p < 0.05. Out all aged 47.8 ± 14.3 years, 71% men and 29% women with sex ratio of 3M:1W were evaluated. The prevalent aUS LC cirrhosis was 43.5%. Only excessive alcohol intake (aOR = 3.5; 95%CI 1.4 - 8.8), leg oedema (aOR = 5.3; 95% CI 2.2 - 12.8), and icicle sign (aOR = 15.1; 95% CI 5.2 - 44) were the most important and signifi-cant independent determinants of aUS LC. For more, only ERS ≥ 60 mm/1st H (aOR = 10.5; 95% CI 1.3 - 82.4; P = 0.025), AST ≥ 60 IU/L (aOR = 10.4; 95% CI 1.3 - 84), indirect bilirubin ≥ 2 mg/dL (aOR = 6.7; 95% CI 1 - 44.7), pro-thrombin < 60% (aOR = 12; 95% CI 1.7 - 86.8), haemoglobin < 10 gr/dL (aOR = 17; 95% CI 1.4 - 202), and NLR ≥ 3 (aOR = 38.4; 95% CI 3.2 - 456) were the most significant and important independent determinants of aUS LC. The non-invasive aUS combined with the current clinical spectrum and biomarkers might be used as a surrogate Gold standard test for the management of chronic liver disease in poor Central Africa.
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