Study of coagulation and platelet dysfunction in chronic liver disease at a tertiary care hospital

Introduction: The liver has a major role in hemostatic system. As most of the Indian studies concentrated mostly on the bleeding tendency in liver disease, in our study we included assessment of bleeding or thrombotic tendency by measuring, VWF, protein c and s, factor VIII level and platelet function. Objectives: To determine the range of hemostatic defects in patients of chronic liver disease by measuring Coagulation profile, VWF, protein c and s, factor VIII level and platelet function. Material and Method: Patients who were defined to have Chronic Liver Disease are included in study. The hemostatic tests which performed for procoagulant proteins were -Prothrombin time, Activated partial thromboplastin time, VWF, Factor VIII assay, Protein C, Protein S and assessment of Platelet Function.Results: Present study included 75 patients of Chronic liver disease. The mean Age was 45.07±12.669 years with M: F ratio 5.8:1. 53% had thrombocytopenia. Mean value of Prothrombin in Class a was 15.340±1.4666, in Class B was 20.488±4.1447 and in Class C was 27.628±7.5530. Increased level (\u003e150%) of VWF was seen in 34 cases (45%). The mean value of Factor VIII was115.66±38.08 %. The mean value of Protein C was 71.63±49.95%. Platelet aggregation test (PAT) was prolonged (\u003e5seconds) with ADP as agonist in 33%. Conclusion: it was observed in our study that laboratory evidences of both hypo and hypercoagulable state were present in patients of chronic liver disease We suggest that further studies with an increased number of samples and more tests of hypercoagulation like antithrombin III, α2-macroglobulin.