Document Type : Research Article
Abstract
Background: The study of coagulation can be traced back to about 400 BC and to the father of Medicine, Hippocrates. The liver is the cornerstone of the coagulation system. The liver is the site of synthesis of fibrinogen and factors Ⅱ, Ⅴ, Ⅶ, Ⅸ, Ⅹ, Ⅺ and Ⅻ. Von Willebrand factor (VWF) is synthetized by the endothelium. When both cellular and plasmatic coagulation are defective, represents a hallmark of advanced liver disease. There is substantial overlap in the hemostatic abnormalities observed in the patients with acute infectious or toxic hepatitis, chronic hepatitis, and cirrhosis, the severity of hepatocellular dysfunction is typically more informative than the etiology.
Aim & Objective:
1. To determine the coagulative abnormalities among liver disease patients admitted in medicine wards.
2. To study the association of coagulation abnormalities with the extent or severity of liver disease.
Methods: Study design: A Cross sectional study. Study setting: Department of pathology. Study duration: June 2019 to June 2020.
Study population: All patients of acute and chronic liver disease admitted to medicine wards in tertiary care hospital such cases included in the study.
Sample size: 200
Results: most common age group was between 31-40yrs of age, i.e., 32% of total patients. 174 (87%) were male population and 26 (13%) were female population.78(39%) cases of cirrhosis, 46(23%) cases of hepatitis, 44(22%) cases of Alcoholic liver disease, and 32(16%) cases of other liver diseases. patients showed coagulation abnormalities considering different parameters i.e., PT, APTT, Platelet count individually or in combinations, and 11(5.5%) patients showed normal test results. About 87% (174/200) had prolonged PT. Mean PT in present study was 28.33±22.29. P value was <0.05 i.e., 0.013 which was statistically significant
Conclusions: Cirrhosis was the most common pathology amongst the study subjects. The PT was most abnormal test among all tests performed. The platelet count and APTT were the least frequently abnormal test. Hence PT was most significant coagulation test among other tests. The proportion of raised PT was highest in alcoholic liver disease and lowest in case of other liver diseases. Coagulation abnormalities were significantly associated with the extent of liver diseases.
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