Abstract
Background : The clotting is a multistep process comprised of sequence of events of platelet plug formation , clotting process , clotting process termination and clot removal .Synthesis of clotting factors and clearance of their activation products took place in liver. The magnitude of clinical features and coagulation abnormalities will vary depending on liver dysfunction . Therefore wide spectrum of abnormalities will be seen in patients of liver cirrhosis. Aims and Objectives : To study the various coagulation abnormalities in liver cirrhosis patients. M ethodology : This 1 year prospective study was conducted in a tertiary hospital for the evaluation of the frequency of coagulation abnormalities in patients with cirrhosis of liver. 82 patients presenting with cirrhosis of liver were selected and were evaluated for coagulation profile. The data was collected via questionnaire form and analyzed by SPSS (Statistical Packages for Social Sciences) version The patients blood were tested for coagulation abnormalities including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count . Results : In the present study, out of 82, fifty (60.9 %) were males and 32 (39.1 ) % were females. According to Child’s Pughs classification,37(45.12 % ) cirrhotic patients were in class A, 13 (15.85% ) in class B and 32 (39.02 % ) in class C. The PT was prolonged (mean + SD = 20.67 ± 4.12 sec) in 44 (53.65 % ) patients, while38 (46.34 %) patients had normal PT which was less than 14 seconds (mean + SD = 12.13 ± 1.01sec). Activated partial thromboplastin time was prolonged in47 (57.31 % ) patients, while35 (42.68 % ) patients had normal APTT which was less than 40 seconds (mean + SD = 33.05 ± 3.06 sec). PT and APTT were significantly raised in cirrhotic patients. Approximately 39% CLD cases had decreased platelet count. Relative risk of GI bleeding with abnormal clotting tests in CLD cases were weakly positive for PT (RR = 1.02; 95% CI, 0.49-2.10), negative for aPTT (RR=0.83; 95% CI, 0.47-1.45), strongly positive for decreased platelet counts (RR = 1.96; 95% CI, 1.08-3.56) . Conclusion : Coagulation abnormalities are commonly seen in cirrhotic liver disease.Decreased platelet count and increased PT and APTT are commonly seen in chronic liver disease. These parameters can be used as prognostic markers. DOI: 10.21276/APALM.1170
Highlights
MethodsThis one year prospective study was conducted at a tertiary hospital .Confirmed cases of cirrhosis (by clinical, biochemical, radiological and prior biopsy if done as described earlier) were selected, both sexes with age >14 years (to exclude pediatric age group)
Clotting is a multistep process comprised of sequence of events of platelet plug formation, clotting process, clotting process termination and clot removal.Synthesis of clotting factors and clearance of their activation products took place in liver
prothrombin time (PT) and APTT were significantly raised in cirrhotic patients
Summary
This one year prospective study was conducted at a tertiary hospital .Confirmed cases of cirrhosis (by clinical, biochemical, radiological and prior biopsy if done as described earlier) were selected, both sexes with age >14 years (to exclude pediatric age group). The exclusion criteria of the study were, patients of cirrhosis with a previous history of coagulation disorders and drug intake that causes changes in the coagulation parameters e.g. Oral. All cirrhotic patients admitted t, that meets the inclusion and exclusion criteria were enrolled in this study. At first an adequate history was taken regarding hematemesis, melena, hemoptysis and hematuria, the presence of petechial hemorrhages or bruises. A focused clinical examination was done regarding the presence of petechial hemorrhages, bruises, the presence of ascites, the grade of hepatic encephalopathy (according to West Haven System) and per rectal examination was done to assess the presence of melena. Blood tests were done for platelet count, PT and APTT. Frequencies and means ± Standard Deviation of data like age PT and APTT was calculated. All values considered significant when p value is 0.05
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
