Clinical significance of accelerated fibrinolysis in liver disease.
We compared site and severity of bleeding in 46 patients with cirrhosis of the liver and accelerated fibrinolysis (defined as a dilute whole-blood clot lysis time less than 2 h) to 44 patients with cirrhosis of the liver and normal fibrinolysis (dilute whole-blood clot lysis time greater than 4 h). Patients with accelerated fibrinolysis had a significantly higher incidence of severe soft-tissue bleeding after trauma and a trend toward increased intracranial bleeding. Mucosal, postoperative, and gastrointestinal bleeding were equally frequent in the two groups. The median partial thromboplastin time was significantly longer, and the median bilirubin and fibrin/fibrinogen degradation product levels were significantly higher in the group with accelerated fibrinolysis, but median prothrombin time, platelet count, and levels of fibrinogen and serum albumin were comparable. The fibrinolytic inhibitor epsilon-aminocaproic acid successfully controlled bleeding in 4 of 6 cases used. Accelerated fibrinolysis may predispose patients with cirrhosis to soft-tissue and intracranial bleeding.
D001663:Bilirubin / Q000097:blood; D001780:Blood Coagulation Tests; D001803:Blood Transfusion; D005342:Fibrinolysis; D006470:Hemorrhage / Q000209:etiology; D006474:Hemorrhagic Disorders / Q000097:blood / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications*; D008111:Liver Function Tests; D010976:Platelet Count; D012709:Serum Albumin / Q000032:analysis; D014947:Wounds and Injuries / Q000150:complications
D012709:Serum Albumin; D001663:Bilirubin