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Gastroenterol Rep (Oxf). 2016 Nov;4(4):315-319. Epub 2015 Dec 15.

Association of conventional haemostasis and coagulation tests with the risk of acute upper gastrointestinal bleeding in liver cirrhosis: a retrospective study.

Li J1,2, Qi X3, Deng H3,2, Peng Y3,2, Shao L4, Ma J4, Sun X3, Li H1, Guo X1.

Author information

1
Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China.
2
Postgraduate College, Dalian Medical University, Dalian, China.
3
Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China xingshunqi@126.com.
4
Department of Gastroenterology, No. 463 Hospital of Chinese PLA, Shenyang, China xingshunqi@126.com.

Abstract

OBJECTIVE:

A retrospective study was performed to compare the difference in platelet count (PLT), prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT), between cirrhotic patients with and without acute upper gastrointestinal bleeding (AUGIB) or acute oesophageal variceal bleeding (AEVB).

METHODS:

Between January 2012 and June 2014, a total of 1734 cirrhotic patients were enrolled and were classified into 'AUGIB' (n = 497) and 'no AUGIB' (n = 1237) groups according to their disease history. They were further divided into 'AEVB' (n = 297) and 'no AEVB' (n = 1259) groups according to the endoscopic findings. Additionally, 178 patients with AUGIB were not assigned to either the 'AEVB' or 'no AEVB' groups due to the absence of any endoscopic findings.

RESULTS:

Compared with the 'no AUGIB' group, the 'AUGIB' group had similar PLT (99.99 ± 89.90 vs.101.47 ± 83.03; P = 0.734) and APTT (42.96 ± 15.20 vs.43.77 ± 11.01; P = 0.219), but significantly higher PT (17.30 ± 5.62 vs.16.03 ± 4.68; P < 0.001) and INR (1.45 ± 0.69 vs.1.31 ± 0.59; P < 0.001). A lower PT was independently associated with the absence of AUGIB (OR = 0.968; 95% CI: 0.942-0.994). Compared with the 'no AEVB' group, the 'AEVB' group had significantly lower PLT (86.87 ± 62.14 vs.101.74 ± 83.62; P = 0.004) and APTT (40.98 ± 7.9 vs.43.72 ± 10.97; P < 0.001), but similar PT (16.53 ± 3.71 vs.16.04 ± 4.68; P = 0.088) and INR (1.35 ± 0.41 vs.1.31 ± 0.59; P = 0.225). A higher PLT was independently associated with the absence of AEVB (OR = 1.004; 95% CI: 1.002-1.006; P = 0.001).

CONCLUSIONS:

PLT was associated with the occurrence of portal hypertension-related bleeding in liver cirrhosis.

KEYWORDS:

bleeding; coagulation; liver cirrhosis; platelets; prothrombin

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