Clinical usefulness of international normalized ratio calibration of prothrombin time in patients with chronic liver disease

2015 ◽  
Vol 102 (2) ◽  
pp. 163-169 ◽  
Author(s):  
Jun Hyung Lee ◽  
Oh Joo Kweon ◽  
Mi-Kyung Lee ◽  
Hyun Woong Lee ◽  
Hyung Joon Kim ◽  
...  
Keyword(s):  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
International Normalized Ratio ◽  
Chronic Liver ◽  
Clinical Usefulness

Periprocedural Bleeding Risk Assessment in Chronic Liver Disease

2017 ◽  
Vol 01 (04) ◽  
pp. 306-312
Author(s):  
Brett Fortune ◽  
David Madoff ◽  
Benjamin May
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Blood Product ◽  
Bleeding Risk ◽  
International Normalized Ratio ◽  
Chronic Liver ◽  
Alternative Methods ◽  
Advanced Liver Disease ◽  
Potential Harm ◽  
Clotting Disorder

AbstractInvasive procedures are common in the management of cirrhosis-related chronic liver disease (CLD). Assessing bleeding risk prior to these procedures is challenging because of commonly seen laboratory abnormalities among traditional testing used to evaluate bleeding risk in patients with advanced liver disease. However, this ‘coagulopathy’ seen in advanced liver disease is not a true bleeding or clotting disorder. The prothrombin time/international normalized ratio (PT/INR) test is frequently elevated in CLD patients, but has been shown to poorly correlate with bleeding risk in this population. A traditional interpretation of this laboratory test can lead to unnecessary transfusion of blood product, procedure delay, or even potential harm to the patient. An understanding of the ‘coagulopathy’ of advanced liver disease and alternative methods, to more accurately assess bleeding risk, allows clinicians to treat safely CLD patients.

Hypoprothrombinemia in Naproxen Overdose

1983 ◽  
Vol 17 (7-8) ◽  
pp. 549-550 ◽  
Author(s):  
Phyllis K. Waugh ◽  
Daniel W. Keatinge
Keyword(s):  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Vitamin K ◽  
Chronic Liver ◽  
Bleeding Disorders ◽  
Clotting Factors ◽  
Direct Inhibition ◽  
Patient Reported

Transient prolongation of the prothrombin time was observed in the setting of a 10-g overdose of naproxen. The patient reported was previously healthy, without chronic liver disease, bleeding disorders, or malnutrition. The most likely mechanism for this effect is direct inhibition of the synthesis of vitamin-K-dependent clotting factors, possibly via production of “abnormal” prothrombin.

A Study on Haematological Manifestations in Patients with Chronic Liver Disease in a Tertiary Care Hospital of North India

2021 ◽  
Vol 8 (25) ◽  
pp. 2222-2228
Author(s):  
Jasmine Kaur ◽  
Navjot Kaur ◽  
Jasleen Kaur ◽  
Navjot Kaur Layal ◽  
Gurkiran Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Tertiary Care ◽  
Meld Score ◽  
Chronic Liver ◽  
Care Hospital ◽  
End Stage Liver Disease ◽  
End Stage

BACKGROUND Chronic liver diseases frequently are associated with haematological abnormalities. Anaemia occurs in about 75% of patients with chronic liver disease. The most common type of anaemia seen in liver cirrhosis is normocytic normochromic anaemia, due to the chronic inflammatory state, blood loss from oesophageal and rectal varices. The purpose of this study was to study the haematological manifestations in patients with chronic liver disease. METHODS A cross-sectional observational study was conducted at Sri Guru Ram Das Institute of Medical Sciences and Research (March 2019 - March 2020). Total of 90 patients with chronic liver disease were included in the study. The population was divided into 2 groups based on the model for end-stage liver disease (MELD) score and the various haematological abnormalities were assessed in these 2 groups. Similarly, haemoglobin (Hb) levels were assessed in 3 groups based on the ChildTurcotte-Pugh (CTP) classification. RESULTS There was a significant correlation between hemoglobina and CTP class (P < 0.001), with the lowest haemoglobin levels in CTP class C group. The correlation coefficient of MELD score and haemoglobin was -0.504 which was significant statistically. Thus, confirming the fact that haemoglobin levels decreases with the progress in the severity of liver cirrhosis. Of 39 patients with haemoglobin < 8 g/dl, 5 (12.8 %) had a MELD score of < 12, whereas 34 patients (87.2 %) had a MELD score of > 12 and was statistically significant (P < 0.0001). Leukocytosis was observed in 41 patients and leucopoenia in 14 patients. The mean prothrombin time was 20.4 seconds and 80 % of the patients had prothrombin time prolonged by more than 6 sec indicating liver damage alters coagulation profile. CONCLUSIONS We found an association between anaemia and indicators of advanced liver disease such as a higher MELD and CPS scores. This study inferred that levels of haemoglobin decrease as the severity of liver disease progresses. Thus, this measure can be used in the initial assessment of cirrhosis patients that needs urgent identification and correction to reduce morbidity and mortality. KEYWORDS Anaemia, Liver Cirrhosis, Model for End-Stage Liver Disease Score, Child-TurcottePugh Class

The Use of Kcentra® in the Reversal of Coagulopathy of Chronic Liver Disease

2017 ◽  
Vol 31 (1) ◽  
pp. 120-125 ◽  
Author(s):  
Deepika Pereira ◽  
Eric Liotta ◽  
Ahmed A. Mahmoud
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
International Normalized Ratio ◽  
Chronic Liver ◽  
Prothrombin Complex Concentrates ◽  
Effective Treatment Option ◽  
Patient Demographics ◽  
Life Threatening ◽  
Clinically Significant ◽  
The Ideal

We aim to describe our experience with the four-factor prothrombin complex concentrates (4F-PCC) Kcentra® at differing doses in patients with liver cirrhosis requiring emergent hemostasis in the setting of major or life-threatening bleeding. An automated query of patients who received Kcentra between January 2014 and March 2016 was performed. Patients who had clinically significant bleeding and received Kcentra for treatment of coagulopathy of chronic liver disease (CCLD) were included in the study. Baseline patient demographics, administration indication, pertinent laboratory values, and other reversal therapies were collected. Four patients met inclusion for analysis. One patient presented with hemopericardium, cardiac tamponade, and shock, and 3 patients presented with intracranial hemorrhage. Each patient experienced an improvement in international normalized ratio (INR) and at least a period of clinical hemostasis after Kcentra administration without complications referable to Kcentra. Kcentra may be a safe, rapid, and effective treatment option for hemorrhagic emergencies associated with CCLD. Further research is needed to determine the ideal monitoring and dosing regimen for use in CCLD.

Diagnostic Value of Routine Liver Tests

1975 ◽  
Vol 21 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Per Winkel ◽  
Klavs Ramsøe ◽  
Jørgen Lyngbye ◽  
Niels Tygstrup
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Diagnostic Value ◽  
Chronic Liver ◽  
Misclassification Rate ◽  
Alkaline Phosphatases ◽  
Diagnostic Categories ◽  
Liver Tests

Abstract In 131 patients on a medical service and 97 patients on a surgical service, in whom a diagnosis of hepatobiliary disease was verified in the hospital, the diagnostic value of routine liver tests performed soon after admission was evaluated by stepwise discriminant analysis. By measurements of alanine aminotransferase, alkaline phosphatases, gamma globulin, prothrombin time, bilirubin, and albumin, half of the medical patients were correctly classified into one of seven diagnostic categories. Aminotransferase contributed most to the classification, being twice as effective as random allocation. Decreasing the number of diagnostic categories to three (hepatitis, fatty liver, and chronic liver disease) increased the frequency of correct allocation to 80%. The allocation of all the patients to seven medical and four surgical diagnostic categories by means of four tests (aminotransferase, alkaline phosphatases, prothrombin time, and bilirubin) was significantly improved by each step, with a misclassification rate of 55% when all tests were used. A reduction of the diagnostic groups to five (hepatitis, fatty liver, chronic liver disease, duct obstruction and tumor) increased the frequency of correct allocation to 63%. The analysis demonstrates the limited diagnostic effectiveness of routine liver tests when used alone. The absolute discrimination values depend on the a priori frequencies of the diagnostic groups investigated, and therefore may vary from time to time and from place to place.

scholarly journals 28 ALBUMIN AND PROTHROMBIN TIME CORRELATE WITH THYROID FUNCTION IN CHILDREN WITH CHRONIC LIVER DISEASE

1992 ◽  
Vol 32 (2) ◽  
pp. 253-253
Author(s):  
T Pasqualini ◽  
E Granillo ◽  
J Rossi ◽  
F Fainstein-Day ◽  
M Balzaretti ◽  
...  
Keyword(s):  
Liver Disease ◽  
Prothrombin Time ◽  
Chronic Liver Disease ◽  
Thyroid Function ◽  
Chronic Liver
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