Assessment of hemostatic profile in patients with mild to advanced liver cirrhosis

作     者：Elisabeth Hannah Adam Madara Mohlmann Eva Herrmann Sonia Schneider Kai Zacharowski Stefan Zeuzem Christian Friedrich Weber Nina Weiler 

作者机构：Department of AnaesthesiologyIntensive Care Medicine and Pain TherapyUniversity Hospital FrankfurtGoethe-University FrankfurtFrankfurt 60590Germany Department of Biostatistics and mathematical modelingUniversity Hospital FrankfurtGoethe-University FrankfurtFrankfurt 60590Germany Department of Internal MedicineDivision of Gastroenterology and HepatologyUniversity Hospital FrankfurtGoethe-University FrankfurtFrankfurt 60590Germany Department of AnaesthesiologyIntensive Care Medicine and Emergency MedicineAsklepios Clinics HamburgHamburg 22043Germany 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第17期

页      面：2097-2110页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Fresenius Kabi GmbH Vifor Pharma GmbH 

主　　题：Liver cirrhosis Model for end-stage liver disease Coagulopathy Multiple electrode aggregometry Thrombelastometry Hemostasis 

摘      要：BACKGROUND Hemostasis of patients suffering from liver cirrhosis is challenging due to both,pro-and anticoagulatory disorders leading to hemostatic alterations with distinct abnormalities of *** changes in conventional coagulation analysis and platelet count are common manifestations of decreased liver synthesis of coagulation factors and reduced platelet count in these ***,conventional coagulation analysis and platelet count do not reflect invivo coagulation status or platelet *** purpose of this present observational study was therefore to assess the haemostatic profile including plasmatic coagulation using thrombelastometry and impedance aggregometry for platelet function in patients suffering from liver *** To assess the hemostatic profile of cirrhotic patients according to model for endstage liver disease(MELD)*** Our study included both in-and outpatients suffering from liver cirrhosis attending the out-and inpatient care of the department of *** and biochemical data as well as medical history including cause of liver cirrhosis,end stage kidney failure and medication with anticoagulants were *** assess the hemostatic profile,platelet function was analyzed by multiple electrode aggregometry(MEA)using Multiplate^■(ADP-,ASPI-and TRAP-test)and thrombelastometry using ROTEM^■(EXTEM,INTEM,FIBTEM).Data were compared using Mann-Whitney U-or χ^*** correlation was performed to analyze the association between MELD Score and results of thrombelastometry and *** A total of 68 patients attending the out-and inpatient care suffering from liver cirrhosis were *** these,50 patients were included and assigned to groups according to MELD score 6 to 11(n=25)or≥17(n=25).Baseline patient characteristics revealed significant differences for MELD score(8 vs 22,P0.0001)and underlying laboratory parameters(international normalized ratio,bilirubine,creatinine)as well as