COMPARISON OF SERUM-ASCITES ALBUMIN GRADIENT (SAAG) IN PORTAL HYPERTENSIVE AND NON-PORTAL HYPERTENSIVE ASCITES

Original Article

Abstract

Background: Ascites is a frequent clinical presentation of several different underlying disorders, the most common of which is liver cirrhosis. To manage acute ascites, it is essential to differentiate portal hypertensive and non-portal hypertensive ascites. The Serum-Ascites Albumin Gradient (SAAG) has proven to be highly sensitive and specific as a diagnostic tool compared to preceding protein-based grading.

Objective: To compare the diagnostic value of SAAG and the study of clinical and biochemical characteristics related to portal hypertensive and non-portal hypertensive ascites.

Study Design: A Cross-sectional comparative Study.

Place and Duration of Study: A study was conducted in the Department of General Medicine at Sandeman Provincial Hospital/Bolan Medical College, Quetta, Pakistan, between July and December 2024.

Methodology: Twenty-eight adult patients with confirmed ascites, as determined by both radiological and clinical findings, were recruited for the study. They were categorized into either a portal hypertensive or a non-portal hypertensive group in equal numbers. SAAG was made equal to the difference between albumin in serum and ascitic fluid. The clinical characteristics, comorbidities, and laboratory tests were recorded. Data analysis involved independent t-tests and chi-square tests, as p < 0.05 was considered statistically significant.

Results: The average age was 57.8 years, with a standard deviation of 14.0, and the average ascites duration was 13.4 months, with a standard deviation of 6.8. The portal hypertensive group showed a significantly higher average SAAG (mean difference= 1.50 g/dL; 95% CI: 1.16-1.85; p < 0.001). Portal hypertension was significantly related to pallor ( χ² = 4.094; p = 0.043); however, other symptoms were not related to it.

Conclusion: SAAG has become a resource-friendly, resouce-friendly, economical, and non-invasive method for differentiating portal hypertensive and non-portal hypertensive ascites, especially in resource-poor areas. It is also recommended that future multicenter studies be conducted to further validate this finding.