Coagulation disorders in decompensated liver cirrhosis and their prognostic value

Abstract

Disorders of haemostasis are frequent in the diseases of the liver, and are in correlation with the degree of liver insufficiency. As a result, bleeding occurs, which, at long end, affects prognosis and life duration in these patients. The aim of this study is to evaluate mean values of some factors of coagulation (factor II, V, VII) and coagulation inhibitors (Anti-thrombin, AT-III) in 69 patients with decompensated alcoholic liver cirrhosis (Child C) and to determine the influence of coagulation disorders on the onset of bleeding and survival rate. We came to conclusion that there was no significant difference in level of coagulation factors and inhibitors between bleeding and non-bleeding patients, although the mean values of investigated parameters were 50% lower for coagulation factors and 60% for coagulation inhibitors in bleeders. The reason for this result we found in positive correlation in decreasing both factors and inhibitors, which agrees with hypothesis that in these cases haemostasis is regulated on new, lower level. Patients with final lethal outcome had significantly low level of AT-III what we considered as an important predictive factor. This results show complex interrelation between haemostasis factors, bleeding, quality of life and survival rate in patients with decompensated liver cirrhosis.