Comparative study of coagulation profile in liver disease in tertiary care hospital

Introduction: The liver is the corner stone of the coagulation system and patients with liver disease are at a substantially increase risk of both thrombosis and haemorrhage. Liver acts as a reticulo endothelial system and regulates coagulation and fibrinolysis by removing these coagulation factors from the circulation. Coagulation disorders in liver disease are usually measured by the prolongation of global screening tests such as the prothrombin time and the activated partial thromboplastin time. Ingeneral, PT determines vitamin K dependent extrinsic factors VII, X, II, V and fibrinogen. The aPTT measures the activities of intrinsic and common pathways of coagulation cascade most sensitive to factor VIII, IX, XI, XII and those of the contact system. Aims and Objectives: To study the alteration in coagulation profile in various liver diseases, to evaluate the risk of bleeding in patients with liver disease and to study the association of coagulation abnormality with the extent of liver disease. Material and Methods: The study included 100 patients with liver diseases attending Medicine and Paediatric department clinics in a teaching tertiary care hospital. These patients were divided into three groups: (1) 40 cases of cirrhosis, (2) 40 cases of viral hepatitis and (3) 20 cases of obstructive jaundice. All these patients were screened for different coagulation tests like Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen and Platelet count. Conclusion: Various abnormalities of coagulation tests vary greatly with different liver disorders, duration of the disorders, and their severity. There are more chances of bleeding when coagulation parameters are altered in cases of cirrhosis but more studies are required in this field to evaluate the thrombotic events seen in patients with liver diseases.