Thrombelastographic changes and early rebleeding in cirrhotic patients with variceal bleeding

T. N. Chau, Y. W. Chan, D. Patch, S. Tokunaga, L. Greenslade, A. K. Burroughs

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84 Citations (Scopus)

Abstract

Background - Routine coagulation tests do not necessarily reflect haemostasis in vivo in cirrhotic patients, particularly those who have bleeding varices. Thrombelastography (TEG) can provide a global assessment of haemostatic function from initial clot formation to clot dissolution. Aim - To evaluate TEG changes in cirrhotic patients with variceal bleeding and their association with early rebleeding. Patients/Methods - Twenty cirrhotic patients with active variceal bleeding had serial TEG and routine coagulation tests daily for seven days. The TEG variables before the day of rebleeding (n = 6) were compared with those of patients without rebleeding (n = 14). Results - Baseline characteristics of the rebleeding and non-rebleeding groups were comparable apart from a higher incidence of uncontrolled infection on the day of rebleeding in the rebleeding group (p = 0.007). The patients in the rebleeding group were more hypocoagulable before the day of rebleeding as shown by longer r (42 v 24 mm, p < 0.001) and k (48 v 13 mm, p < 0.001) and smaller a (12 v 38°, p < 0.001) compared with the mean of daily results of the non-rebleeding group. Routine coagulation tests, however, showed no significant differences between the two groups. Conclusion - The results of serial TEG measurements suggest that hypocoagulability may be associated with early rebleeding in cirrhotic patients.

Original languageEnglish
Pages (from-to)267-271
Number of pages5
JournalGut
Volume43
Issue number2
DOIs
Publication statusPublished - 1998

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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