COAGULOPATHY IN CHRONIC LIVER DISEASE. A DISTURBED COAGULATION HARMONY IN RELATION TO SEVERITY OF LIVER DISEASE.

Abstract

Coagulation of blood is the most important vital function to obviate excessive bleeding. Many coagulation factors are involved in this process, among which most of them are synthesised in liver. Cirrhosis is dened as a nal stage of chronic liver disease. It is associated with disturbances in the synthetic and metabolic function of liver and can leads to abnormalities in the coagulation process. The hemostatic system is a delicate balance between prothrombotic and antithrombotic processes. Liver acts as a key organ in the synthesis of various coagulation factors and hence participate in both primary and secondary haemostasis. Identication of specic biochemical markers that can predict the severity of liver cirrhosis and the probability of bleeding tendency can help the physician in early identication of complications. This study was done to analyse the efcacy of coagulation tests like PT, APTT, brinogen and platelets in predicting the severity of liver disease and its complications, to study the relevance and signicance of coagulation tests in relation to bleeding complications in patients with CLD. We conducted a cross sectional observation study involving 100 patients diagnosed with CLD. The mean levels of PT and Results: APTT found to have positive association and a strong correlation with increasing grades of MELD and Child Pugh score, whereas the mean platelet count and serum brinogen levels showed a strong negative association. Signicant correlations between PT, APTT, and declining brinogen and platelet levels and GI bleeding were observed. Coagulation parameters like PT, APTT, brinogen and platelet levels can be used for grading the severity of CLD and also predict the propensity of a patient with CLD to bleed.