Comparison of the serum fibrinogen level and International Normalized Ratio in the assessment of the risk of gastrointestinal bleeding in decompensated cirrhosis

M. Somi, Masood Faghih Dinevari, L. Alizadeh, A. Riazi, S. Abbasian, Zeinab Nikniaz
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引用次数: 1

Abstract

Introduction: Gastrointestinal (GI) bleeding is the most life-threatening complication of cirrhosis and it's predicting is crucial for the management of cirrhotic patients. The present study aimed to assess the relationship between INR and plasma fibrinogen level and the risk of GI bleeding using in cirrhotic patients. Methods: In the present cross-sectional study, seventy-eight cirrhotic patients were enrolled. We assessed demographic, biochemical, hematologic parameters in all patients. Underlying diseases and the etiology of cirrhosis were documented. The Child-Pugh and the Model for End-stage Liver Disease (MELD) scores were used to assess the severity of liver cirrhosis. The history of bleeding episodes within 6 months before inclusion were recorded. A blood sample was drowned and fibrinogen and prothrombin time (PT) were measured and INR was calculated. Results: The patients' mean age was 51.23±15.08 years and 40 (51.3%) were male. About 17 patients (%21.7) had a history of GI bleeding within 6 months before the study. The significant difference was observed between the two groups who experienced bleeding and who did not regarding the fibrinogen level (P < 0.05). The fibrinogen level was a better predictive marker of bleeding in cirrhotic patients (AUC: 0.87). According to the results of predictive tests, the fibrinogen level had a sensitivity of (77%) and specificity of (%94) in the prediction of bleeding with the cut-off value of 182.5. Conclusion: The results of the present study showed that the fibrinogen level is a better predictor of bleeding in cirrhotic patients compared with INR.
血清纤维蛋白原水平与国际标准化比值评估失代偿期肝硬化消化道出血风险的比较
胃肠道出血是肝硬化最严重的并发症,其预测对肝硬化患者的治疗至关重要。本研究旨在评估INR和血浆纤维蛋白原水平与肝硬化患者消化道出血风险之间的关系。方法:在本横断面研究中,78例肝硬化患者入组。我们评估了所有患者的人口学、生化和血液学参数。记录肝硬化的基础疾病和病因。Child-Pugh和终末期肝病模型(MELD)评分用于评估肝硬化的严重程度。记录入组前6个月内的出血史。取血,测定纤维蛋白原和凝血酶原时间(PT),计算INR。结果:患者平均年龄51.23±15.08岁,男性40例(51.3%)。约17例患者(21.7%)在研究前6个月内有胃肠道出血史。出血组与无出血组纤维蛋白原水平比较,差异有统计学意义(P < 0.05)。纤维蛋白原水平是肝硬化患者出血的较好预测指标(AUC: 0.87)。根据预测试验结果,纤维蛋白原水平预测出血的敏感性为77%,特异性为94%,临界值为182.5。结论:本研究结果表明,与INR相比,纤维蛋白原水平能更好地预测肝硬化患者出血。
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