Assessment of coagulation abnormalities associated with liver diseases

Paper Details

Research Paper 01/12/2017
Views (264) Download (91)

Assessment of coagulation abnormalities associated with liver diseases

Sher Bacha, Abid Ul Ghafoor, Hashmat Ullah Khan, Ali, Eiman Sumayyah, Sahib Zada, Tahir Khan, Nikhat Ilahi, Suliman Khan, Wasim Sajjad
Int. J. Biosci.11( 6), 89-99, December 2017.
Certificate: IJB 2017 [Generate Certificate]


Coagulation abnormalities in patients with liver diseases occur frequently. The disorders include, changes in procoagulant factors, natural anticoagulant factors, fibrinolytic, antifibrinolytic, inhibitors of coagulation factors, endothelial dysfunction, thrombocytopenia and thrombocytopathy disturbing the normal hemostatic balance, results in different clinical conditions from abnormal bleeding to thrombosis. This study was aimed to assess the coagulation abnormalities associated with liver diseases. Routine coagulation tests such as Prothrombin Time, Activated Partial Thromboplastin Time and Platelet count were carried out for all patients. Data and samples of 278 patients admitted in Gastroenterology Ward of Hayatabad Medical Complex Peshawar (excluding patients with congenital coagulation disorders). Patients with prolonged PT= 91.7%, (mean value 28.6 ± 15.1 sec), with cumulative percentage of patients with International Normalized Ratio=3 was 78%, prolonged APTT= 88%, with (mean value = 50.6 ± 19 sec), Prolonged PT and APTT both= 84.9%, low platelet count= 59%. No significant difference was found between male and female patients regarding coagulation disorder. Patients with gastrointestinal bleeding were 13%.The study concluded that most of the patients were at risk for abnormal bleeding or thrombo-embolism. These patients would need prophylaxis before going through surgery and would need special care after any trauma or injury.


BrummelZiedins K. 2013. Models for thrombin generation and risk of disease. Journal of Thrombosis and Haemostasis. 11(s1), 212-23.

Adams GL, Manson RJ, Turner I, Sindram D, Lawson JH. 2007. The balance of thrombosis and hemorrhage in surgery. Hematology/oncology clinics of North America. 21(1), 13-24

Aird WC. 2007. Phenotypic heterogeneity of the endothelium. Circulation research. 100(2), 174-90.

Lisman T, Leebeek FW, Mosneir LO. 2001. Thrombin activatable fibrinolysis inhibitors deficiency in cirrhosis is not associated with increased plasma fibrinolysis. Gastroenterology. 121(1), 131-139.

Ali SA, Donahue RM, Qureshi H, Vermund SH. 2009. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. International Journal of Infectious Diseases. 13(1), 9-19.

Siddique SA, Ahmed M, Ghani MH, Memon MA, Mustafa G, Ghori MA. 2011. Coagulation abnormalities in patients with chronic liver disease in Pakistan. Journal of Pakistan Medical Association. 61(4), 363-7.

Henao NA, Munoz CAM, Gutierrez JCR. 2011. Chronic Hepatopathy: bleeding vs. thrombosis. Revista Colombiana de Gastroenterologia. 26(4),  280-285.

Ahmad Hameed, Naeem S, Shaikh AS, Khursheed I, Hameed A, Naveed IA. 2006. An Assessment of Coagulation Parameters in Liver Cirrhosis. Biomedica. 22, 75-77.

Patryck Lloyd-Donald, Abhinav Vasudevan, Peter Angus, Paul Gow, Johan Mårtensson, Neil Glassford, Glenn M. Eastwood, Graeme K Hart, Rinaldo Bellomo. 2017. Coagulation in acutely ill patients with severe chronic liver disease: Insights from thromboelastography. Journal of Critical Care 38, 215–224.

Malik AY, Amjad F, Haq S, Hayee A. 1999. Acquired Coagulopathy in Female suffering from Acute and Chronic Liver Diseases. Mother & Child. 37(4), 119-126.

Bajaj JS, Bhattacharjee J, Sarin SK. 2001. Coagulation profile and platelet function in patients with extrahepatic portal vein obstruction and non-cirrhotic portal fibrosis. Journal of Gastroenterology and Hepatology 16, 641-646.

Devrajani BR, Talpur MAA, Rahman AA, Shah SZA, Das T, Devrajani T. 2012. Coagulapathies in Patients with Liver Cirrhosis. World Applied Science Journal. 17(1), 01-04.

Munoz SJ, Stravitz RT, Gabriel DA. 2009. Coagulopathy of acute liver failure. Clinics in Liver Disease. 13(1), 95-107.

Northup PG, McMahon MM, Ruhl AP. 2006. Coagulopathy does not fully protect hospitalized cirrhosis patients from peripheral venous thromboembolism. American Journal of Gastroenterology. 101(7),1524-1528.

Wintrobe MM. 2009. Wintrobe’s clinical hematology (1), Lippincott Williams & Wilkins.