Study the Proportion of Coagulative Abnormalities Among Liver Disease Patients and To Predict Severity in Cirrhosis Patients by Using Child-Pugh-Turcotte Score at Tertiary Care Center
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2072-2080
AbstractBackground: The study of coagulation can be traced back to about 400 BC and to the father of Medicine, Hippocrates. Liver is an important organ of the body having functions of synthesis of plasma proteins and a range of blood clotting factors being produced, some of them exclusively in the organ. All of them are deranged in various liver disorders .Liver plays a predominant role in the regulation of haemostasis. Both cellular and plasmatic coagulation are defective, representing a hallmark of advanced liver disease. Laboratory tests, coagulation tests and liver function tests are useful in the evaluation, management and assessment of prognosis. They provide a sensitive, noninvasive method of screening for the presence of liver dysfunction.
Aim & Objective: 1.To study the proportion of 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. 3. To predict severity in cirrhosis patients by using Child-Pugh-Turcotte score.
Methods: Study design: Prospective Cross sectional study. Study setting: Department of pathology of tertiary care center. Study duration: April 2021 to April 2022.
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: Majority of cases found in age group of 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: Majority of cases presented with cirrhosis. The PT was most abnormal test among all tests performed. The platelet count and APTT was 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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