Abstract
OBJECTIVE: To evaluate the hemostatic abnormalities in patients with cirrhosis and their relation with
severity of liver dysfunction as assessed by Child Pugh Score.
BACKGROUND: Important role is played by liver in hematopoeisis as well as hemostasis. Therefore liver
dysfunction due to any reason is associated with hematological and complex hemostatic abnormalities.
Important abnormalities include decreased production of coagulation and anticoagulation factors,
excessive fibrinolysis, low platelet count etc. These are manifested by abnormal laboratory tests for
these variables. For descriptive or prognostic indicator of these abnormalities Child– Pugh score is
generally used.
MATERIAL AND METHODS: Present study was done at the Postgraduate laboratory and hospital of ISRA
University Hyderabad. The study was approved by ethical committee of ISRA University. Sixty four
patients with liver cirrhosis were taken for study and divided according to Child Pugh Score as Class A,
B and C; 47 were males and 17 were females. All age groups were included and mean age of group A, B
and C was determined.
The patients fulfilled inclusion and exclusion criteria. Data was collected after taking consent and blood
was drawn to perform Coagulation parameters, platelets and fibrinolytic parameters in their respective
analyzer machines.
RESULTS: In Child Pugh Score A , B and C patients, Mean Platelet count was 375.36 ±39.479, 343.30 ±
58.793, 277.03 ±55.061 per uL and Mean Fibrinogen level was 333.90 ±45.007, 261.07 ±70.622, 207.33 ±
38.484 per mg / dl respectively which showed a significant decrease in patients from Child Pugh Score
A through C and Mean Platelet count and Mean Fibrinogen level Showed a negative Correlation with
Child Pugh Score having r- = -0.640, p = 0.0001 and r- = -0.579, p 0.0001 respectively. In Child Pugh
Score A , B and C patients, Mean Prothrombin time was 11.09 ±0.831, 12.15 ±2.828, 16.66 ±2.541 per
second, Mean Activated partial thromboplastin time was 27.09± 4.657, 33.50 ±2.284, 35.62 ±1.779 per
second, Mean D-dimer level was 195.45 ±13.633, 212.96 ±37.845, 234.14 ±47.287 per ug/L and Mean
bleeding time was 4.63 ±1804, 7.88 ±2.833, 9.33 ±2.496 per minute respectively which showed a
significant increase in patients from class A through C and showed a positive correlation with Child
Pugh score.
CONCLUSION: It was concluded that PT, APTT, BT and D-dimer correlated positively while Fibrinogen
level and Platelet count correlated negatively with Child Pugh score.
Hanozia Hassan, Asmat Kamal Ansari, Salma Farrukh Memon. (2017) Haemostatic Abnormalities in Patients with Cirrhosis and their Relation with Severity of Liver Dysfunction as Assessed by Child Pugh Score, Journal of Liaquat University of Medical and Health Sciences, Volume-16, Issue-2.
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