Full Article: PDF
Scientific Object Identifier: http://s-o-i.org/1.1/TAS-09-65-16
DOI: https://dx.doi.org/10.15863/TAS.2018.09.65.16
Language: English
Citation: Ayub M, Noor S, Aleem Z (2018) DERRANGED COAGULATION PROFILE & RISK OF GASTROINTESTINAL BLEEDING. ISJ Theoretical & Applied Science, 09 (65): 106-111. Soi: http://s-o-i.org/1.1/TAS-09-65-16 Doi: https://dx.doi.org/10.15863/TAS.2018.09.65.16 |
Pages: 106-111
Published: 30.09.2018
Abstract: Objective: Purpose of conducting this study was to determine risk of gastrointestinal bleeding due to abnormal coagulation profile in patients with chronic liver disease. Study design and setting: This study was done in in DHQ Teaching Hospital Gujranwal Medical College Gujranwala, Pakistan. Study duration: This study was started in January 2018 and completed in July 2018 consisted on period of 7 months duration Patients and Methods: Patients with chronic liver disease with deranged coagulation profile and signs and symptoms of gastrointestinal bleeding presenting to outpatient door or emergency ward of study institution during study period were selected. Proper history taken and physical examination was done followed by necessary investigations such as USG abdomen, clotting profile (PT, APTT, INR), CBC with platelet count, LFTs, RFTs and stool culture for occult blood or malena. Unstable patients presented in emergency ward well given initial resuscitation and bleeding were stopped with conservative management successfully. Only those cases were selected having No chronic disease other than CLD, Not taking any anticoagulant for any disease and no family history of bleeding disorder. A performa was designed containing necessary questions like age, duration of disease, signs and symptoms of CLD such as ascites, hematemesis, per rectal bleeding, malena etc. Data was analyzed on Microsoft office and statistical software. Relative risk was calculated with 95% confidence interval. Results: Total 280 cases reported with chronic liver disease out of which 150 cases were having gastrointestinal bleeding having history of malena and hematemesis. There were 76.7% cases with prolonged prothrombin time. In 88.6% cases APTT was prolonged. 88.6% were having low platelet count less than 1.5?105. There were 58.7% male and 41.3% female cases. Age of patients was in range of 30-75 years with mean age of 50.4 years ±14.6 SD. Confidence interval was 95%, relative risk 1.55 and P value was less than 0.05. In 70% cases hematemesis or malena was present. In 42.7% only hematemesis, 63.3% having malena and in 46.6% both were present. 31.3% cases had encephalopathy,48.7% fever, 60.7% jaundice,25.3% hepatomegaly, 69.3% spleenomegaly, 56.7% ascites and 8% cases had spider angioma. Conclusion: Chronic liver disease is most prevalent disease in Pakistan in which coagulation profile is deranged with prolonged PT, APTT and decreased platelet count. Gastrointestinal hemorrhage is common presentation in CLD.
Key words: Complications of CLD, Derrange coagulation profile, gastrointestinal bleeding.
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