Back to Search
Start Over
Platelet Count Does Not Predict Bleeding in Cirrhotic Patients: Results from the PRO-LIVER Study.
- Source :
-
The American journal of gastroenterology [Am J Gastroenterol] 2018 Mar; Vol. 113 (3), pp. 368-375. Date of Electronic Publication: 2017 Dec 19. - Publication Year :
- 2018
-
Abstract
- Objectives: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear.<br />Methods: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years.<br />Results: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child-Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800-1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50 × 10 <superscript>3</superscript> /μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11-3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16-3.62; P=0.013) independently predicted overall bleeding events.<br />Conclusions: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Hemorrhage epidemiology
Humans
International Normalized Ratio
Italy epidemiology
Liver Cirrhosis blood
Male
Middle Aged
Platelet Count
Prognosis
Proportional Hazards Models
Prospective Studies
Prothrombin Time
Risk Factors
Severity of Illness Index
Gastrointestinal Hemorrhage epidemiology
Liver Cirrhosis epidemiology
Thrombocytopenia epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1572-0241
- Volume :
- 113
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The American journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 29257146
- Full Text :
- https://doi.org/10.1038/ajg.2017.457