Evaluation of Ascitic Fluid to Serum Bilirubin Ratio to Distinguish Transudates and Exudates

Abstract

Background: Many diseases are known to lead to the formation of free fluid within the peritoneal cavity. The evaluation of a patient with ascites requires that the cause of the ascites to be established. Diagnostic paracentesis (50-100ml) should be part of the routine evaluation of the patient, with ascites. The present study was conducted to evaluate the ascitic fluid to serum bilirubin ratio to distinguish between transudates and exudates.
Material and Methods- The present prospective observational study was conducted at Departments of General Medicine and Medical Gastroenterology at Vydehi Institute of Medical Sciences and Research centre. Demographic data, history, clinical examination and details of investigations were recorded in the case record form, patients were subjected to specific investigations to find out the underlying etiology. Diagnostic paracentesis was done. All the data was analysed using SPSS software.Results- The sensitivity and specificity of Ascitic Bilirubin/Sr. Bilirubin ratio was 16.7% and 17.4% respectively. The PPV and NPV was 26.92% and 10.25% respectively using SAAG criteria. The sensitivity and specificity of Ascitic Bilirubin/Sr. Bilirubin ratio was 50% and 62.74% respectively. The PPV and NPV was 26.92% and 10.25% respectively using Light’s criteria.Conclusion – Our study concludes that diagnostic accuracy of Ascitic Bilirubin/Sr. Bilirubin ratio was very less when compared with SAAG criteria and better when compared with Lights criteria.