Platelet count as a screening tool for compensated cirrhosis in chronic viral hepatitis

Table 1 Baseline demographics

	Training (n = 715)	Validation (n = 312)	P value
Age (yr)	45.6 (10.7)	44.5 (11.1)	0.1
Male/female (%)	66/34	66/34	1.0
Platelets (× 109/L)	186.7 (64.4)	190.6 (68.2)	0.4
Alanine aminotransferase (IU/L)	103.8 (88.1)	105.1 (89.1)	0.8
Aspartate aminotransferase (IU/L)	69.9 (55.0)	68.0 (53.3)	0.6
Albumin (g/dL)	3.9 (0.46)	3.9 (0.39)	0.2
Alkaline phosphatase (IU/L)	82.3 (39.2)	79.0 (29.2)	0.1
Prothrombin time (s)	13.0 (1.3)	12.9 (1.1)	0.3
Total bilirubin (mg/dL)	0.81 (0.48)	0.77 (0.45)	0.2
Ishak fibrosis	2.4 (1.8)	2.3 (1.7)	0.3
HAI inflammation	8.0 (3.0)	7.9 (3.1)	0.5
HBV/HCV/HDV (%)	23/68/8	23/68/9	1.0

Values presented as mean (SD) unless otherwise noted.

Table 2 Spearman correlations between Ishak fibrosis and liver tests within training cohort

	R	P value
Platelets	-0.49	< 0.0001
AST	0.51	< 0.0001
ALT	0.37	< 0.0001
Alkaline phosphatase	0.35	< 0.0001
Prothrombin time	0.33	< 0.0001
Albumin	-0.30	< 0.0001
Total bilirubin	0.18	< 0.0001

Table 2 shows the calculated Spearman R and P value for the correlations between Ishak fibrosis and the indicated laboratory value. ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.

Table 3 Area under the curve using selected liver tests within the training cohort

Platelets	ALT	AST	Alkaline phosphatase	Prothrombin time
0.86 (0.82, 0.90)	0.65 (0.59, 0.71)	0.76 (0.71, 0.81)	0.76 (0.71, 0.81)	0.77 (0.71, 0.82)

Values presented as Area Under the Receiver Operating Characteristics curve (AUROC) (95% Wald confidence interval). Table 3 displays the calculated AUROC and 95% Wald confidence interval for each selected laboratory marker in identifying cirrhosis (Ishak ≥ 5) in the training cohort and the entire cohort. Overall, when compared by Delong test, platelets have a significantly greater AUROC value than each of the other laboratory values (P > 0.002). ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.

Table 4 Performance of optimal platelet cut-offs in validation cohort

	Platelet cut-off (× 109/L)	AUROC	Sensitivity (%)	Specificity (%)	Positive predictive value (%)	Negative predictive value (%)
Entire validation cohort	143	0.85 (0.76-0.93)	79	84	33	98
HBV	143	0.81 (0.53-1.00)	83	82	29	98
HCV	143	0.83 (0.72-0.94)	75	86	31	98
HDV	143	0.87 (0.74-1.00)	100	60	47	100

Table 4 displays the calculated cut-offs and sensitivity, specificity, positive predictive values, and negative predictive values for each the calculated optimal cut-off within the validation cohort. AUROC: Area Under the Receiver Operating Characteristics curve. HBV: Hepatitis B virus; HCV: Hepatitis C virus; HDV: Hepatitis D virus.

Table 5 Performance of platelet cut-offs in training cohort

Platelet counts (× 109/L)	Sensitivity (%)	Specificity (%)	Positive predictive value (%)	Negative predictive value (%)
130	67	91	57	94
140	73	86	48	95
143	74	83	44	94
150	78	78	38	95

Table 5 displays the calculated sensitivity, specificity, positive predictive values, and negative predictive values for four cut-off platelet counts within the training cohort.