A. Blasi, A. Calvo, V. Prado, E. Reverter, JC. Reverter, M. Hernández-Tejero, F. Aziz, A. Amorós, Cárdenas, J. Fernández.
Coagulation failure in patients with acute -on-chronic liver failure and decompensated cirrhosis: beyond the international normalized ratio.
Hepatology 2018; 68: 2325-2337
The aim of the study was to characterize the coagulation profile in 24 patients patients with acute decompensation (AD) and 36 patients with acute-on-chronic liver failure (ACLF) and its relationship with systemic inflammation, transfusion requirements, bleeding events and short-term survival. Blood samples for thromboelastometry were obtained at admission and 72 hours thereafter.
Patients with ACLF showed more hypocoagulable characteristics than patients with AD (prolonged time to initial fibrin formation and clot formation and decreased maximum clot firmness and α-angle values) and higher prevalence of hypocoagulable profile (61% versus 16%). Hypocoagulativity was associated with systemic inflammation and higher short term mortality rate (45% vs 16%) but not with bleeding or transfusion requirements.