Coagulation abnormalities in patients with cirrhosis in a tertiary hospital Sangli : A prospective study

  • Sheetal M Sale
  • Vaibhav P Mane Bharati Vidyapeeth Deemed University Medical College And Hospital ,Sangli.
  • Vishrabdha R Pawar
  • Dajiram G Mote
  • Sushant N Mohite
  • Vanisha Dhaka
Keywords: Cirrhosis, Prothromobin, Clotting, Coagulation abnormalities, Chronic liver disease,

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.  Methodology : 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

Author Biography

Vaibhav P Mane, Bharati Vidyapeeth Deemed University Medical College And Hospital ,Sangli.
Department Of PathologyAssociate Professor

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Published
2017-06-13
Section
Original Article