Evaluation of the performance of biochemical ratios and albumin’s gradient in the etiological exploration of ascitic fluid
Main Article Content
Abstract
Biochemical exploration of effusion fluids plays a crucial role in the diagnosis of un-derlying pathologies. This study aimed to evaluate the performance of biochemicalratios and the albumin gradients in the diagnostic process of ascitic fluids.
Methods-The study was prospective, involving 56 samples from ascitic patients. For each patient, five biochemical parameters (glucose, protein, albumin, LDH, and total amy-lase) were performed in ascites and plasma samples. The ascites/plasma protein, LDH ratios, and serum-ascites albumin gradients (SAAG), were calculated to evaluate their
diagnostic relevance.
Results - Twenty-eight adult patients presenting ascites were included in this study,18 women (64.28%) and 10 men (35.71%) with an M/F sex ratio of 0.55. The most effi-cient parameters to distinguish the transudate/exudate concept were: Ascitic proteins (p =0.01), ascitic/plasma proteins (p =0.004), ascitic LDH (p =0.011), ascitic/plasma LDH ratio (p =0.013), ascitic albumin (p = 0.012), ascitic albumin/plasma ratio (p = 0.002) and ascitic glucose/plasma ratio (p = 0.02). A threshold of 14 g/L of Albumine had a better positive predictive value than a threshold set at 20 g/L (73 vs 46%). The sensitivity, spe-
cificity, diagnostic efficiency,and positive and negative predictive values for SAAG were 100%, 64%, 78%, 64%, and 100% respectively, and for the modified Light’s criteria 78%, 86%, 82%, 80%, and 82% which hadbetter diagnostic efficiency and specificity than the classic Light’s criteria with the respective comparative value 82 vs 78% and 86 vs 57% but less sensitivity (78 vs 100%). The criteria H20-30, H25, and TAL had good diagnostic efficiency with 75%, 75%, and 78% respectively.
Conclusion -The integration of biochemical ratios and the albumin’s gradient signifi-cantly improves the differential diagnosis of ascites. It is essential to promote the use of these parameters in clinical practice to improve the treatment of patients with ascites.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
A- Open Access statement and license:
1-Open Access statement:
JFMO provides immediate open access to published content in support of the idea that free access to research helps support the dissemination of knowledge and ideas in the field of medical science. All articles will be published under Creative Commons licenses.
All published data is immediate free access to the work and permits any user to read, download, copy, distribute print, search, or link to the full texts of articles.
The users of any published material in the JFMO must act in accordance with the Creative Commons Licenses CC BY-NC-ND 4.0.
2-License:
All published data is distributed following the Creative Commons Licenses CC BY-NC-ND 4.0. This license is allowing others to download the works and share them with others as long as they correctly cite the manuscript, No changes are allowed to the original manuscript and the manuscript must be used only for non for profit or non-commercial purposes.
This work is licensed under a Creative Commons AttributionNonCommercial-NoDerivatives 4.0 International License.
3-Self Archiving:
Authors are permitted and encouraged to share online their articles published in JFMO (e.g., in institutional repositories or on their website), as it can lead to productive exchanges, as well as earlier and greater citation of published work.
