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Published on: August 1, 2018
Bleeding time in patients with hepatic cirrhosis
J C Blake1, D Sprengers, P Grech
1Hepatobiliary and Liver Transplantation Unit, Royal Free Hospital and School of Medicine, Hampstead, London.
BMJ (Clinical Research Ed.)
|July 7, 1990
Summary
Abnormal bleeding time is frequent in cirrhosis patients, even with normal platelet counts and prothrombin times. Liver disease severity, indicated by bilirubin levels, significantly impacts bleeding risk, necessitating careful assessment before procedures.
Area of Science:
- Hepatology and Hematology
- Clinical Biochemistry
Background:
- Cirrhosis often impairs primary hemostasis, leading to bleeding complications.
- Assessing bleeding risk in cirrhosis patients is crucial for managing invasive procedures.
Purpose of the Study:
- To determine the frequency of abnormal bleeding time in cirrhosis patients.
- To correlate bleeding time with factors affecting primary hemostasis and liver disease severity.
Main Methods:
- Prospective study of 100 cirrhosis inpatients.
- Bleeding time measured using the Simplate device; abnormal if >10 minutes.
- Assessed platelet count, prothrombin time, bilirubin, and blood urea.
Main Results:
- 42% of patients had prolonged bleeding times (>10 minutes).
- Lower platelet counts and higher bilirubin levels correlated with longer bleeding times.
- Standard "safe limits" for platelet count and prothrombin time did not reliably predict normal bleeding time.
Conclusions:
- Prolonged bleeding time is common in cirrhosis, irrespective of standard coagulation parameters.
- Bilirubin concentration is a key determinant of bleeding time in cirrhosis.
- Bleeding time assessment is recommended for patients with elevated bilirubin or poor liver function before invasive procedures.
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