Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension

Table 1 Demographic characteristics of participants n (%)

Variables	Patients with cirrhosis and portal hypertension	Healthy controls	P value
	(n = 770)	(n = 31)
Sex			0.0251
Male	554 (71.9)	16 (51.6)
Female	216 (28.1)	15 (48.4)
Age (yr)	53.3 ± 11.3	46.0 ± 12.0	< 0.0011
Causes of cirrhosis			NA
Hepatitis B	622 (80.8)	-
Hepatitis C	39 (5.1)	-
Alcoholic cirrhosis	61 (7.9)	-
Autoimmune liver disease	24 (3.1)	-
Others	24 (3.1)	-
Level of liver function			NA
I	230 (29.9)	-
II	209 (27.1)	-
III	119 (15.5)	-
Undefined	212 (27.5)	-
Splenic artery internal diameter (mm)	5.35 (4.67-6.18)	4.60 (4.32-5.32)	0.0021
Proper hepatic artery internal diameter (mm)	3.63 (2.97-4.43)	3.72 (3.14-4.19)	0.830
S/P ratio	1.48 (1.19-1.82)	1.36 (1.13-1.48)	0.0121

¹Indicates significant difference between patients with cirrhosis and portal hypertension and healthy controls. Data were presented as number (%) for sex, cause of cirrhosis, and level of liver function; mean ± SD for age; and median (interquartile range: Q1-Q3) for the internal diameters of the splenic artery and proper hepatic artery and the splenic artery internal diameter/proper hepatic artery internal diameter (S/P) ratio because data were not normally distributed. Data of patients with cirrhosis and healthy controls were compared using Pearson χ² for sex, two-sample t test for age, and Mann-Whitney U test for S/P ratio, respectively. NA: Not assessed.

Table 2 Univariate logistic regression analyses of associations between splenic artery internal diameter/proper hepatic artery internal diameter ratio and complications in patients with cirrhosis and portal hypertension n (%)

Complication	Total	Patients with normal S/P ratio	Patients with abnormal S/P ratio	OR (95%CI)	P value
	(n = 770)	(n = 130)	(n = 640)
Ascites
Yes	426 (55.7)	304 (53.5)	122 (61.9)	0.708 (0.508-0.986)	0.0411
No	339 (44.3)	264 (46.5)	75 (38.1)	Reference
Hepatic encephalopathy
Yes	77 (10.1)	58 (10.2)	19 (9.6)	1.065 (0.617-1.838)	0.820
No	688 (89.9)	510 (89.8)	178 (90.4)	Reference
Esophageal and gastric varices
Yes	209 (27.4)	166 (29.3)	43 (21.8)	1.483 (1.010-2.175)	0.0441
No	555 (72.6)	401 (70.7)	154 (78.2)	Reference
Upper gastrointestinal bleeding
Yes	111 (14.5)	90 (15.9)	21 (10.7)	1.581 (0.954-2.621)	0.076
No	653 (85.5)	477 (84.1)	176 (89.3)	Reference
Collateral circulation formation
Yes	611 (79.9)	464 (81.7)	147 (74.6)	1.518 (1.033-2.230)	0.0341
No	154 (20.1)	104 (18.3)	50 (25.4)	Reference

¹Indicates significant association. The incidences of ascites, hepatic encephalopathy, esophageal and gastric varices, Upper gastrointestinal bleeding, and collateral circulation formation were not available in 5, 5, 6, 6, and 5 patients, respectively. OR: Odds ratio.

Table 3 Comparisons of preoperative and postoperative portal vein hemodynamic indexes in patients with cirrhosis and portal hypertension who received splenectomy (n = 17)

Variables	Before splenectomy	After splenectomy	P value
Portal vein
Pressure (cm H2O)	39.19 ± 5.87	27.04 ± 3.03	< 0.0011
Flow rate (mL/min)	1005.50 (833.00-1811.25)	868.00 (539.50-1215.75)	0.116
Maximum flow velocity (cm/s)	23.85 (18.53-31.20)	15.85 (12.68-20.58)	0.0091
Mean flow velocity (cm/s)	20.85 (15.90-25.95)	12.25 (10.48-16.40)	0.0111
Hepatic artery
Flow rate (mL/min)	153.50 (128.75-188.77)	365.00 (190.00-511.00)	0.0481
Minimum flow velocity (cm/s)	16.25 ± 15.23	32.60 ± 15.23	0.0011
Resistance index	0.74 ± 0.05	0.64 ± 0.07	< 0.0011

¹Indicates significant difference between preoperative and postoperative values. Data were presented as mean ± SD, or median (interquartile range: Q1-Q3) if not normally distributed. Preoperative and postoperative data were compared using paired t-test or Wilcoxon sign-rank test if data were not normally distributed.

Table 4 Comparisons of preoperative and postoperative routine blood test results in patients with cirrhosis and portal hypertension who received splenectomy (n = 17)

Variable	Before splenectomy	After splenectomy	P value
ALT (U/L)	29.39 ± 16.86	36.47 ± 28.9	0.439
AST (U/L)	33 (21.9-45.4)	37 (26.65-48.45)	0.653
Total bilirubin (μmol/L)	16.8 (12.95-24.9)	21.4 (16.2-39.55)	0.0051
Direct bilirubin (μmol/L)	4.74 ± 2.13	7.56 ± 4.31	0.0031
Albumin (g/L)	37.67 ± 3.73	36.74 ± 3.28	0.439
Creatinine (μmol/L)	70.44 ± 22.28	58.69 ± 14.78	0.0361
WBC count (E + 09/L)	1.73 (1.26-2.24)	9.05 (6.43-12.84)	< 0.0011
RBC count (E + 12/L)	3.45 ± 0.73	3.42 ± 0.47	0.87
Platelet count (E + 09/L)	47.41 ± 24.48	307 ± 132.4	< 0.0011

¹Indicates significant difference between preoperative and postoperative values. Data were presented as mean ± SD, or median (interquartile range: Q1-Q3) if not normally distributed. Preoperative and postoperative data were compared using paired t test or Wilcoxon sign-rank test if data were not normally distributed. ALT: Alanine amino transferase; AST: Aspartate amino transferase; WBC: White blood cell; RBC: Red blood cell.