A prospective study included 266 patients (mean age 62 y, 68% men) with cirrhosis referred for staging of liver disease. 145 patients were included in the derivation set and 121 in the validation set. Platelet count/spleen diameter ratio (PC/SD ratio) was the only variable that independently predicted presence of oesophageal varices (OV). When the platelet count was given in n/mm3 and spleen diameter in mm, a PC/SD ratio cutpoint of 909 (for presence of OV) was estimated from the corresponding receiver-operating characteristics curve. Classification using the decision rule was compared with a definitive diagnosis of OV from endoscopy. In derivation set the sensitivity was 100% and the specificity was 93%. In the validation set, the sensitivity was 100% and the specificity was 42%. In 145 patients with compensated cirrhosis (from both sets) the sensitivity was 100% and the specificity was 71%. In this group, all patients with PC/SD > 909 were free of OV, whereas 74% of patients with PC/SD at or below 909 had OV.
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