Prolonged bleeding time in cirrhotic patients: relationship to peripheral vasodilation and severity of cirrhosis.
A prolonged bleeding time (> 540 s), measured with a Simplate single template device, was found in 0% of 50 patients with chronic hepatitis and 38% of 154 cirrhotic patients. Cirrhotic patients with a prolonged bleeding time (n = 59) had lower platelet counts (P < 0.001) and a longer prothrombin time (P < 0.001) and activated partial thromboplastin time (P < 0.001) compared with cirrhotic patients with a normal bleeding time (n = 95). A weak but significant negative correlation existed between the bleeding time and platelet count in cirrhotic patients (n = 154, r = -0.3668, P < 0.001). Patients with decompensated cirrhosis had a longer bleeding time in comparison to patients with compensated cirrhosis (621 +/- 39 vs 478 +/- 27 s, respectively, P < 0.01). The prolonged bleeding time was also discovered in 25% of 83 cirrhotic patients with a platelet count > 80 x 10(9)/L and a prothrombin time < 17 s (usually taken as safe limits for invasive procedures). Twenty-seven of the 83 cirrhotic patients received a haemodynamic study by Swan-Ganz catheterization. A lower systemic vascular resistance was found in cirrhotic patients with an abnormal bleeding time than in cirrhotic patients with a normal bleeding time (844 +/- 57 vs 1171 +/- 60 dyne.s.cm-5, respectively, P < 0.001), whereas both groups had similar hepatic venous pressure gradient (16.2 +/- 1.2 vs 18.1 +/- 1.4 mmHg, respectively, P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Hsu
W C
WC
Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Lee
F Y
FY
Lee
S D
SD
Tsai
Y T
YT
Lin
H C
HC
Lin
R S
RS
Meng
H C
HC
Wang
T F
TF
Wang
S S
SS
Lo
K J
KJ
D001760:Bleeding Time; D005260:Female; D006505:Hepatitis / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors; D014655:Vascular Resistance; D014664:Vasodilation