The coagulation changes associated with acute variceal bleeding in patients with HCV-induced cirrhosis as assessed by rotational thromboelastometry

Autor: Mona A. Abu El-Makarem, Aml A. Mohammad, Ola A. Afifi, Nehal I. Abbas, Tarek A. Abd El-Zaher, Safaa M. Abdel Halim, Aliaa S. Abd El-Fattah
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Egyptian Liver Journal, Vol 14, Iss 1, Pp 1-11 (2024)
Druh dokumentu: article
ISSN: 2090-6226
DOI: 10.1186/s43066-024-00323-w
Popis: Abstract Background and objectives Alterations of hemostasis in patients with decompensated cirrhosis are complex. Accordingly, standard coagulation tests are not feasible to evaluate bleeding risk in these patients. The aim of this study was to assess the coagulation kinetics in cirrhotic patients with variceal bleeding using rotational thromboelastometry (ROTEM). ROTEM including EXTEM, INTEM, and FIBTEM which represent extrinsic, intrinsic pathways, and fibrinogen activity, respectively, was measured in 60 cirrhotic patients with variceal bleeding who were compared to 60 patients with stable cirrhosis. APTEM was optionally performed to evaluate fibrinolysis. Results Overall, cirrhosis patients displayed features of hypofibrinolysis, whereas the state of hypocoagulability was significantly higher in cirrhotic patients with variceal bleeding (61.7% versus 30%, p = 0.001). Values of clot formation time (CFT) by EXTEM and INTEM correlated positively with those of model for end-stage liver disease score (r = 0.529, p = 0.001, and r = 0.595, p
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