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Infection and hemostasis in decompensated cirrhosis: a prospective study using thrombelastography
G V Papatheodoridis1, D Patch, G J Webster
1Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, UK.
Hepatology (Baltimore, Md.)
|March 30, 1999
Summary
Bacterial infections significantly impair blood clotting (hemostasis) in patients with decompensated cirrhosis. Successful infection treatment typically restores normal hemostasis within five days.
Area of Science:
- Hepatology
- Infectious Diseases
- Hematology
Background:
- Bacterial infections are frequent in decompensated cirrhosis.
- The impact of infection on hemostasis in cirrhosis remains understudied.
Purpose of the Study:
- To investigate the effect of bacterial infections on hemostasis in patients with decompensated cirrhosis.
- To assess changes in routine hemostasis tests and thrombelastography (TEG) during infection and recovery.
Main Methods:
- Prospective evaluation of 84 cirrhotic patients (Child-Pugh B/C).
- Assessed routine hemostasis tests and TEG on admission/first day of infection and 5 days later.
- Compared hemostasis parameters in patients with and without infection, and during infection resolution or persistence.
Main Results:
- Infection led to significant deterioration of routine hemostasis tests (except platelets) and all TEG parameters.
- Hemostasis parameters improved significantly within 5 days in patients whose infections resolved.
- Persistent infection was associated with worsening TEG parameters (r, k, alpha).
Conclusions:
- Bacterial infections commonly impair hemostasis in decompensated cirrhosis.
- Successful infection treatment generally normalizes hemostasis within five days.
- Infection may contribute to the bleeding tendency in cirrhotic patients.