Prognostic Value of Clotting and Fibrinolytic System in Cirrhotic Patients

Yi, Sun Young; Lee, Han Chu

Abstract

Backgroud/Aims: The plasma activity of factor VII and prekallikrein may be independent predictors of survival in liver cirrhosis. We analyzed the relation between these coagulation factors and survival
METHODS
Sixty-five patients with cirrhosis were followed up for about 2 years to evaluate the relation between clotting factors and survival.
RESULTS
During follow-up, 17 patients died of liver failure or gastrointestinal hemorrhage. In univariate analysis, the values of bilirubin and D-dimer (a marker of fibrinolysis in vivo) were higher in the 17 nonsurvivors than in survivors. On the othe hand, the values of albumin, prothrombin activity, fibrinogen, prekallikrein and factor VII were lowe in the 17 patients who died. In addition, a more prolonged activated partial thromboplastin time wa observed in the 17 patients who died. However, in multivariate analysis (Cox' s model), only prekallikrein and factor VII were independent predictors of survival. Namely, 93% of patients with prekallikrein value less than 32% died within 32 months of follow-up, and 93% of patients with factors VII levels less than 34% died within 10 months of follow-up.
CONCLUSIONS
This study suggests that factor VII is an early predictor of survival and may be useful in identifying cirrhoti patients who need liver transplantation.