Correlation of Liver Diseases with Coagulation Abnormalities: A Tertiary Care Hospital-based Study

Background: The liver plays a central role in maintaining hemostatic balance and serves as a key organ in the regulation of both coagulation and fibrinolysis. In individuals with liver cirrhosis, the majority of coagulation factors and natural anticoagulants are markedly decreased due to compromised hepatic protein synthesis. Coagulation profiles, alongside liver function tests, are essential tools for diagnosing, monitoring, and determining the severity and prognosis of liver disease. These tests are highly sensitive indicators of liver disorders. Typically, prothrombin time (PT) ranges from 11 to 16 s, while activated partial thromboplastin time (aPTT) ranges from 26 to 40 s. PT primarily evaluates the function of the extrinsic and common pathways. On the other hand, aPTT assesses the intrinsic and common pathways. Aim and Objective: (1) Study of coagulation profile in liver disease patients at a tertiary care hospital. (2) To study the association of coagulation abnormalities with the extent or severity of liver disease. Methodology: A Cross-sectional study was conducted in tertiary care hospital. One hundred patients clinically diagnosed with liver disorders were included in this study from January 2023 to January 2024. Results: The highest number of cases were observed in the 31–40-year age group, accounting for 35% (35 cases), followed by 25% (25 cases) in the 41–50 age group. A male predominance was observed, with 78% of the patients being male and 22% female. Cirrhosis was the most common diagnosis (45 cases), followed by Hepatitis (21 cases), alcoholic liver disease with 19 cases, and 15 cases categorized under other liver conditions. A majority of patients (93 cases) demonstrated abnormal coagulation profiles, whereas only 7 showed normal coagulation status. Elevated PT (PT >24 s) was seen in 82 cases, while 18 had PT values ≤16 s. However, statistical analysis revealed no significant correlation between PT and liver disease at a significance level of P < 0.05. Regarding aPTT, 60% of the cases had values >40 s, 32 cases fell within the 27–40 s range, and 8 cases had aPTT values <26 s. Conclusions: Prolonged PT and aPTT values in advanced liver cirrhosis reflect significant liver parenchymal damage, leading to reduced synthesis of clotting factors and an increased risk of bleeding. Early detection of these changes through PT and aPTT assessments can help identify bleeding risks before clinical complications arise, allowing timely intervention and preventing life-threatening hemorrhagic events.