Association Of Serum Prothrombin Index With Early Post-Operative Complications Following Liver Resection

Introduction: The Prothrombin Index (PI) is a critical measure of coagulation status, reflecting the liver's ability to synthesize clotting factors. In the context of liver resection, a procedure associated with a significant risk of bleeding and other complications, the assessment of PI becomes paramount. This study investigates the association between serum Prothrombin Index and early postoperative complications following liver resection. Methods: This Prospective observational study was conducted among the indoor patients of the Hepatobiliary unit of the surgery department in Dhaka Medical College Hospital, from 1st January 2023 to 29th December 2023. All patients admitted to the hepatobiliary unit of the department of surgery, Dhaka Medical College Hospital were considered as the study population. A total of 40 patients were selected as study subjects through a purposive sampling technique. Data were analyzed by Statistical Package for Social Sciences (SPSS) version 20.0. Result: In the early postoperative period, the association between prothrombin index (PI) and various complications was assessed. Regarding bile leak, no statistically significant association was observed, with the probability of bile leak being 0.237 for patients with a PI <50%. In contrast, a significant association was found between PI and postoperative bleeding, where a PI <50% showed a probability of 0.04 for hemorrhage, making this result statistically significant. Lastly, the association between PI and sepsis revealed no significant findings, with a probability of 0.479 for sepsis in patients with a PI <50%. Overall, a lower PI was significantly linked to an increased risk of postoperative bleeding, but not to bile leak or sepsis. Conclusion: The study findings highlight the clinical importance of assessing both the initial and postoperative Prothrombin Index concerning outcomes following liver resection. Consequently, utilizing the initial and early postoperative Prothrombin Index as a clinical parameter can enhance the optimization of postoperative patient care.