title: Patterns of acquired bleeding disorders in a tertiary care hospital.
abstract: Bleeding disorders constitute a large proportion of referrals to hematology departments. Worldwide, acquired causes of bleeding are commoner than inherited ones. To identify the spectrum of these disorders, we evaluated all referrals for bleeding encountered in this tertiary care centre over a one-year period. Of the total 1342 cases, 1040 (77.5%) had underlying exclusively acquired causes, whereas inherited causes constituted 302 cases (22.5%). Amongst acquired causes, disseminated intravascular coagulation was seen in 297 (28.6%), hepatic coagulopathy in 218 (20.9%), neurosurgical causes (intracranial bleeds) in 154 (14.8%), malignancy in 89 (8.6%), and miscellaneous multiple acquired causes including those due to anticoagulant drug overdose in 282 patients (27.1%). Referrals for isolated prolonged prothrombin time or thrombocytopenia were common, but were excluded from this study because not all presented with bleeding. Prompt laboratory work-up and precise identification of acquired causes of bleeding is the key to planning appropriate patient management including transfusion support.
authors.affiliation: Haematololgy Department, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
authors.forename: Bhushan
authors.initials: B
authors.lastname: Asthana
authors.forename: Prashant
authors.initials: P
authors.lastname: Sharma
authors.forename: Ravi
authors.initials: R
authors.lastname: Ranjan
authors.forename: Prachi
authors.initials: P
authors.lastname: Jain
authors.forename: Ajisha
authors.initials: A
authors.lastname: Aravindan
authors.forename: Pravas
authors.initials: P
authors.lastname: Chandra Mishra
authors.forename: Renu
authors.initials: R
authors.lastname: Saxena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000453:epidemiology*; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult