Ascites is a clinical scenario frequently encountered in primary care, internal medicine
and gastroenterology. Formal guidelines on its approach and management exist and recommend
measuring the serum-ascites albumin gradient (SAAG) as part of the routine evaluation
of new-onset ascites to guide the clinician in determining the underlying etiology
[
[1]
,
[2]
]. SAAG is in reality a discrete numerical variable that was dichotomized in early
studies from which ascites guidelines support their recommendations [
[3]
,
[4]
]. For example, a threshold of ≥1.1 g/dL for SAAG indicates portal hypertension as
the likely cause of ascites [
[1]
,
[2]
].Keywords
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References
- Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome : 2021 practice guidance by the American association for the study of liver diseases.Hepatology. 2021; 74: 1014-1048https://doi.org/10.1002/hep.31884
- Guidelines on the management of ascites in cirrhosis.Gut. 2021; 70: 9-29https://doi.org/10.1136/gutjnl-2020-321790
- The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites.Ann Inter Med. 1992; 117: 215-220
- High protein ascites in patients with uncomplicated hepatic cirrhosis.Am J Med Sci. 1974; 267: 275-279
- Dichotomizing continuous variables in statistical analysis: a practice to avoid.Med Decis Mak. 2012; 32: 225-226https://doi.org/10.1177/0272989X12437605
- STARD 2015 guidelines for reporting diagnostic accuracy studies : explanation and elaboration.Br Med J Open. 2016; 6e012799https://doi.org/10.1136/bmjopen-2016-012799
- Serum protein concentration and portal pressure determine the ascitic fluid protein concentration in patients with chronic liver disease.Transl Res. 1983; 102: 250-259
Article info
Publication history
Published online: April 15, 2022
Accepted:
April 8,
2022
Received in revised form:
April 3,
2022
Received:
January 14,
2022
Identification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
