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Evidence Base
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Evidence Base: Liver & Ascites
History
How helpful is the history in predicting the finding of ascites in a patient?
The history can separate patients into high or low probability of having ascites and thus the need for a thorough physical examination for ascites. The presence of recent increased abdominal girth, weight gain, or ankle edema or a history of hepatitis has been found to be suggestive of ascites. Ascites is unlikely in the absence of increased abdominal girth and extremely unlikely in men without recent ankle edema.
The following data is a composite of several studies of the value of history in diagnosing ascites (Williams and Simel, JAMA 1992).
| HELPFUL |
LR+ |
LR- |
Sensitivity |
Specificity |
| Increased abdominal girth |
4.16 |
0.17 |
0.87 |
0.77 |
| Weight gain |
3.20 |
0.42 |
0.67 |
0.79 |
| h/o hepatitis |
3.20 |
0.80 |
0.27 |
0.92 |
| Ankle edema |
2.80 |
0.10 |
0.93 |
0.66 |
| h/o CHF |
2.04 |
0.73 |
0.47 |
0.73 |
|
