Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India

Kishore, Sanjeev; Bhatia, Gautam; Kaushik, Sanjay; Bhatia, Umesh

doi:10.5005/jp-journals-10050-10077

Cited by 2 publications

(7 citation statements)

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“…Similar findings were observed by Bhatia et al [1] and Shah and Jansari et al [2] study. In the present study, male preponderance was observed in cases of liver diseases; similar findings were observed in other studies as by Tarun Kotadiya et al [3] and Bhatia et al [1] 225 patients of various liver diseases with various clinical manifestations were studied for coagulation abnormalities by doing coagulation tests like, Prothrombin time and Activated partial thromboplastin time. 25 normal individuals were included as controls.…”

Section: Discussionsupporting

confidence: 91%

“…Table 6 shows prolonged APTT in 25.9% cases of other liver diseases, 25.3% cases of Hepatitis, and 46.2% cases of Cirrhosis. Similar findings were seen in studies by Tarun Kotadiya 3 and Bhatia et al [1] . [11] 66.6 1962…”

Section: Discussionsupporting

confidence: 91%

“…study [1] .In Hepatitis, prolong PT is detected in 45.5% cases which is also comparable with Bhatia et al study [1] . The APTT is the test for intrinsic coagulation pathway.…”

Section: Discussionsupporting

confidence: 87%

“…[5] 30 30 100 D.S. Singh B. Dube et al [6] 40 40 100 Aspsia Sdoultati et al [7] 34 34 100 S. Gurdoy et al [8] 35 33 94 Israel Spector Milton Cor et al [9] 50 50 100 [3] 20(bleeder) 16 80 20 11 55 40 9 22 20(non bleeder) 3 15 Bhatiya et al [1] 156 74 49 69 18 26 75 26 34.6 Poonam Rastogi et al [5] 18 14 77.7 Israel Spector Milton Cor et al [9] 19 9 64 Talat Naheed et al [10] 100 The PT is the test widely accepted as a means to monitor patients having disorders of specific coagulation factors in the extrinsic and common pathway of coagulation. Table 4 shows high PT in 38.5% cases of Alcoholic liver diseases, 45.5% cases of Hepatitis and 53.8% in cirrhosis patients; which is comparable with Tarun Kotadiya study [3] .…”

Section: Discussionmentioning

confidence: 99%

“…It plays a predominant role in the regulation of haemostasis. Both cellular and plasmatic coagulation are defective, representing a hallmark of advanced liver disease [1] . Patients with liver disease are at a substantially increased risk of thrombosis and hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

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Coagulation profile in liver diseases: A study of 250 cases in a tertiary care hospital

Prajapati¹,

Shah²,

Gidwani³

et al. 2020

Int. J. Clin. Diagn. Pathol.

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Introduction:The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as it synthesizes most of the factors of coagulation cascade and fibrinolytic proteins. So it is responsible for regulation of haemostasis. Hepatic disorders are widely present in tropical countries and are responsible for morbidity and mortality. Aims and Objectives: The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases using tests like prothrombin time (PT), and activated partial thromboplastin time (APTT). Materials and Methods:The study was conducted in the laboratory of Pathology department, during the period from October 2019 to June 2020. This study included 225 patients clinically diagnosed with liver disease who were divided into three categories: 1-cirrhosis, 2-other liver disease and 3-Hepatitis.The coagulation tests PT and APTT were performed and the results were evaluated in groups. 25 normal patients were taken as controls. Result: Out of 250 patients, 190(85%) were males and 60(24%) were females. A total of 13(6%) patients were of cirrhosis, 100 (44%) were of viral hepatitis and jaundice, and 112 (50%) were of other liver diseases and 25 normal patients (10%). Prothrombin time showed marked significant prolongation in all liver diseases. In cirrhosis: 90-100% bleeders showed elevation of Prothrombin time and non bleeders showed elevation in 50-55% cases. In viral hepatitis: 45% cases showed rise in PT. In Alcoholic liver diseases; 38.5% cases showed rise in PT. APTT is quite Significant in cirrhosis. In cirrhosis, Bleeders showed elevation of APTT in100% cases and non bleeders show 50% cases. In viral hepatitis, 25.3% rise in APTT in Alcoholic liver diseases, 25.9%cases showed rise in APTT. Conclusion:In advancing liver diseases, damage to liver parenchyma resulting in reduced production of coagulation proteins so there is increase in PT and APTT which increase the risk of bleeding tendencies. Prolongation of PT and APTT in advancing liver cirrhosis indicates damage to the liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

“…study [1] .In Hepatitis, prolong PT is detected in 45.5% cases which is also comparable with Bhatia et al study [1] . The APTT is the test for intrinsic coagulation pathway.…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Coagulation profile in liver diseases: A study of 250 cases in a tertiary care hospital

Prajapati¹,

Shah²,

Gidwani³

et al. 2020

Int. J. Clin. Diagn. Pathol.

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Safety and Effectiveness of an Anti-Xa-based Unfractionated Heparin Protocol for Impella Percutaneous Ventricular Assist Devices

Berman,

Lozano,

Kitten

et al. 2023

Hosp Pharm

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Background: Impella devices are used for mechanical circulatory support in patients with cardiogenic shock or those undergoing high-risk percutaneous coronary intervention (PCI). Anticoagulation protocols in this population are not well established and are complicated by concomitant use of purge solutions containing unfractionated heparin (UFH) and intravenous UFH continuous infusion (CI) for systemic anticoagulation. Objectives: To evaluate thrombotic and bleeding complications when using a novel UFH protocol with a reduced initial UFH CI dose of 6 units/kg/hour targeting an anti-Xa goal of 0.3 to 0.5 units/mL in patients receiving Impella support. Methods: This single-center, retrospective study included 41 patients on Impella support who received an UFH purge solution and/or an IV UFH infusion. The primary outcome was overall composite bleeding. Secondary outcomes included thrombotic events and systemic UFH exposure. An exploratory analysis was performed to identify risk factors for bleeding. Results: Anti-Xa values were in therapeutic range 46% of the time while on support (interquartile range 16.6%-75%), with a median IV UFH dose of 6 units/kg/hour. The overall bleeding rate was 29.2%, with 6 minor bleeds and 2 major bleeds with no fatal bleeding or intracranial hemorrhage. Rate of overall thrombosis was 4.9%, including 1 ischemic stroke and 1 occurrence of limb ischemia. Conclusion: Use of a modified UFH protocol to target an anti-Xa goal of 0.3 to 0.5 units/mL resulted in bleeding and thrombotic event rates similar to previous literature. This protocol utilizing an initial rate of 6 units/kg/hour may be a useful approach to achieve therapeutic anticoagulation while accounting for UFH exposure from the purge solution and minimizing need for frequent calculations.

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Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India

Abstract: Background:The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins.

Cited by 2 publications

References 6 publications

Coagulation profile in liver diseases: A study of 250 cases in a tertiary care hospital

Coagulation profile in liver diseases: A study of 250 cases in a tertiary care hospital

Safety and Effectiveness of an Anti-Xa-based Unfractionated Heparin Protocol for Impella Percutaneous Ventricular Assist Devices

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