Original Article This work is licensed under the Creative Commons Attribution 4.0 License. Published by Pacifc Group of e-Journals (PaGe) Coagulation Abnormalities in Patients with Cirrhosis in A Tertiary Hospital Sangli : A prospective Study Introduction The liver plays a central role in the clotting process. Acute and chronic liver diseases are invariably associated with coagulation disorders due to multiple causes including: decreased synthesis of clotting and inhibitor factors, decreased clearance of activated factors, quantitative and qualitative platelet defects, hyperfbrinolysis, and accelerated intravascular coagulation. [1,2,3,4,5 ] Most coagulation factors are produced in liver, but the response of each factor to liver disease is variable due to differences in biologic half lives and acute phase reactions . [5,6] The PT is usually prolonged frst, then APTT. Factor VII: shortest biologic half life, often affected earliest with largest decrease in plasma level. Factor VII also decreases earliest with warfarin treatment. Factor VIII: may be normal or elevated due to acute phase reactants. Factors XI and XII:have long biologic half lives, and may be normal until liver disease is advanced. [7,8,] However the D-Dimer is usually normal which is helpful to differentiate liver disease from DIC .[9,10,] The bleeding tendency accounts for increased risk of morbidity and mortality in patients with liver disease undergoing diagnostic or therapeutic invasive procedures . [11] Coagulation disorders in liver disease are extensive, complex and expensive to treat. Many mechanisms can cause the coagulation changes, but many can be attributed to cytokine activation. Sepsis further impairs hemostasis in patients with liver cirrhosis bleeding from esophageal Sheetal Mahesh Sale 1 , Vaibhav Pandurang Mane 1 *, Vishrabdha Rahul Pawar 1 , Dajiram G .Mote 2 , Sushant Narayan Mohiteand 1 and Vanisha Dhaka 1 Department of Pathology , Bharati Vidyapeeth Deemed University Medical College And Hospital , Sangli. India Department of Surgery , Bharati Vidyapeeth Deemed University Medical College And Hospital , Sangli, India ABSTRACT Background: Clotting is a multistep process comprised of sequence of events of platelet plug formation , clotting process , clotting process termination and clot removal.Synthesis of clotting factors and clearance of their activation products took place in liver. The magnitude of clinical features and coagulation abnormalities will vary depending on liver dysfunction .Therefore wide spectrum of abnormalities were seen in patients of liver cirrhosis. Aims and Objectives: To study the various coagulation abnormalities in patients of liver cirrhosis. Methodology: This 1 year prospective study was conducted in a tertiary hospital for the evaluation of the frequency of coagulation abnormalities in patients with cirrhosis of liver. 82 patients presenting with cirrhosis of liver were selected and were evaluated for coagulation profle. The data was collected via questionnaire form and analyzed by SPSS (Statistical Packages for Social Sciences) version. Patients blood was tested for coagulation abnormalities including prothrombin time (PT), activated partial thromboplastin time (aPTT) and platelet count. In this study design control group of normal people without cirrhosis was not considered. Results: In the present study, out of 82, ffty (60.9 %) were males and thirty two (39.1 ) % were females. According to Child’s Pughs classifcation, 37(45.12 % ) cirrhotic patients were in class A, 13 (15.85% ) in class B and 32 (39.02 % ) in class C. The PT was prolonged (mean + SD = 20.67 ± 4.12 sec) in 44 (53.65 % ) patients, while38 (46.34 %) patients had normal PT which was less than 14 seconds (mean + SD = 12.13 ± 1.01sec). Activated partial thromboplastin time was prolonged in47 (57.31 % ) patients, while 35 (42.68 % ) patients had normal APTT which was less than 40 seconds (mean + SD = 33.05 ± 3.06 sec). PT and APTT were signifcantly raised in cirrhotic patients. Approximately 39% CLD cases had decreased platelet count. Relative risk of GI bleeding with abnormal clotting tests in CLD cases were weakly positive for PT (RR = 1.02; 95% CI, 0.49-2.10), negative for aPTT (RR=0.83; 95% CI, 0.47-1.45), strongly positive for decreased platelet counts (RR = 1.96; 95% CI, 1.08-3.56) . Conclusion: Coagulation abnormalities are commonly seen in cirrhotic liver disease.Decreased platelet count and increased PT and APTT are commonly seen in chronic liver disease. These parameters can be used as prognostic markers. Keywords: Cirrhosis, Prothromobin, Clotting , Coagulation Abnormalities, Chronic Liver Disease, DOI: 10.21276/APALM.1170