Thrombelastographic changes and early rebleeding in cirrhotic patients with variceal bleeding
Open Access
- 1 August 1998
- Vol. 43 (2), 267-271
- https://doi.org/10.1136/gut.43.2.267
Abstract
Background—Routine coagulation tests do not necessarily reflect haemostasis in vivo in cirrhotic patients, particularly those who have bleeding varices. Thrombelastography (TEG) can provide a global assessment of haemostatic function from initial clot formation to clot dissolution.Aim—To evaluate TEG changes in cirrhotic patients with variceal bleeding and their association with early rebleeding.Patients/Methods—Twenty cirrhotic patients with active variceal bleeding had serial TEG and routine coagulation tests daily for seven days. The TEG variables before the day of rebleeding (n = 6) were compared with those of patients without rebleeding (n = 14).Results—Baseline characteristics of the rebleeding and non-rebleeding groups were comparable apart from a higher incidence of uncontrolled infection on the day of rebleeding in the rebleeding group (p = 0.007). The patients in the rebleeding group were more hypocoagulable before the day of rebleeding as shown by longer r (42v 24 mm, p k(48 v 13 mm, pa (12 v 38°, pConclusion—The results of serial TEG measurements suggest that hypocoagulability may be associated with early rebleeding in cirrhotic patients.Keywords
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