Bleeding complications in acute liver failure.
UNLABELLED: In patients with acute liver failure (ALF), elevated prothrombin time and thrombocytopenia can fuel a perception of a bleeding tendency. However, the incidence, site, risk factors, and clinical significance of bleeding complications have not been quantified in a large cohort of patients with ALF. We studied 1,770 adult patients enrolled in the ALF Study Group Registry between 1998 and 2016. Bleeding complications and blood component transfusions were collected for 7 days after admission. The relationship of bleeding complications to 21-day mortality was assessed. Despite a median international normalized ratio of 2.7 and platelet count of 96 × 10
CONCLUSIONS: Despite a perceived bleeding diathesis, clinically significant bleeding is uncommon in patients with ALF; bleeding complications in patients with ALF are markers of severe systemic inflammation rather than of coagulopathy and so portend a poor prognosis. (Hepatology 2018;67:1931-1942).
Published In/Presented At
Stravitz, R. T., Ellerbe, C., Durkalski, V., Schilsky, M., Fontana, R. J., Peterseim, C., Lee, W. M., & Acute Liver Failure Study Group (2018). Bleeding complications in acute liver failure. Hepatology (Baltimore, Md.), 67(5), 1931–1942. https://doi.org/10.1002/hep.29694
Medicine and Health Sciences
Department of Family Medicine, Department of Family Medicine Residents