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Bleeding predictors in factor-XI-deficient patients

B Brenner1, A Laor, H Lupo

  • 1Thrombosis & Hemostasis Unit, Rambam Medical Center, Technion, Haifa, Israel.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|March 10, 1998
PubMed
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Bleeding risk in factor XI deficiency is linked to severity. Major deficiency strongly predicts bleeding, while minor deficiency and blood group O show slight contributions.

Area of Science:

  • Hematology
  • Genetics

Background:

  • Bleeding in factor XI deficiency is primarily injury-related.
  • Factors influencing bleeding, especially in mild cases, require further definition.

Purpose of the Study:

  • To identify and analyze parameters affecting bleeding tendency in factor XI-deficient individuals.
  • To develop a predictive model for bleeding manifestations.

Main Methods:

  • Logistic regression analysis of bleeding parameters in 45 families with factor XI deficiency.
  • Documentation of bleeding manifestations in homozygous, heterozygous, and normal factor XI genotype subjects.
  • Correlation analysis of factor XI levels, factor VIII, and von Willebrand factor with bleeding.

Main Results:

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  • Bleeding occurred in 58% of homozygous/doubly heterozygous, 20% of heterozygous, and 9% of normal genotype subjects.
  • Major factor XI deficiency was a strong predictor of bleeding (P=0.011); bleeding correlated negatively with factor XI level (r=-0.36).
  • Minor deficiency and blood group O had slight contributions; operative procedures involving mucosal membranes increased bleeding risk.

    • Conclusions:

    • Factor XI level is a key determinant of bleeding risk in factor XI deficiency.
    • A predictive model demonstrated good accuracy (78% overall, 82% in heterozygotes) for bleeding manifestations.