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Procedure-related bleeding risk in patients with cirrhosis and severe thrombocytopenia
- Source :
- European Journal of Clinical Investigation
- Publication Year :
- 2020
-
Abstract
- Background Gaps of knowledge still exist about the potential association between severe thrombocytopenia and increased risk of procedure‐associated bleeding in patients with liver disease. Methods In this narrative review, we aimed at examining the association between procedure‐related bleeding risk and platelet count in patients with cirrhosis and severe thrombocytopenia in various settings. We updated to 2020 a previously conducted literature search using MEDLINE/PubMed and EMBASE. The search string included clinical studies, adult patients with chronic liver disease and thrombocytopenia undergoing invasive procedures, any interventions and comparators, and haemorrhagic events of any severity as outcome. Results The literature search identified 1276 unique publications, and 15 studies met the inclusion criteria and were analysed together with those identified by the previous search. Most of the new studies included in our analysis did not assess the association between post‐procedural bleeding risk and platelet count alone in patients with chronic liver disease. Furthermore, some results could have been biased by prophylactic platelet transfusions. A few studies found that severe thrombocytopenia may be predictive of bleeding following percutaneous liver biopsy, dental extractions, percutaneous ablation of liver tumours and endoscopic polypectomy. Conclusions Currently available literature cannot support definitive conclusions about the appropriate target platelet counts to improve the risk of bleeding in cirrhotic patients who underwent invasive procedures; moreover, it showed enormous variability in the use of prophylactic platelet transfusions.
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Cirrhosis
Percutaneous
Carcinoma, Hepatocellular
Clinical Biochemistry
MEDLINE
Blood Loss, Surgical
Reviews
thrombocytopenia
Review
030204 cardiovascular system & hematology
Postoperative Hemorrhage
Chronic liver disease
Esophageal and Gastric Varices
Biochemistry
Severity of Illness Index
03 medical and health sciences
Liver disease
0302 clinical medicine
Internal medicine
Biopsy
medicine
Humans
Paracentesis
Platelet
biopsy
030212 general & internal medicine
Endoscopy, Digestive System
Ligation
medicine.diagnostic_test
liver cirrhosis
platelet count
platelet transfusions
business.industry
Liver Neoplasms
General Medicine
medicine.disease
Severe thrombocytopenia
Liver Transplantation
Liver
Tooth Extraction
Catheter Ablation
Biopsy, Large-Core Needle
business
Subjects
Details
- ISSN :
- 13652362
- Volume :
- 51
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- European journal of clinical investigation
- Accession number :
- edsair.doi.dedup.....3ec129ebee3832849250ced209ab54f9