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June 1967

Laboratory Tests of Hemostasis: The Relation to Hemorrhage in Liver Disease

Author Affiliations

Washington, DC

From the George Washington University Medical Division, the District of Columbia General Hospital. Dr. Spector was a US Public Health Service postdoctoral Fellow in Hematology and is presently chief, Medical Service at the US Public Health Service Hospital, Detroit. Dr. Corn is Associate Professor of Medicine, George Washington University School of Medicine.

Arch Intern Med. 1967;119(6):577-582. doi:10.1001/archinte.1967.00290240099006

In PATIENTS with liver disease one or more abnormalities of hemostasis can frequently be demonstrated in the laboratory.1 Although it is generally believed that these abnormalities predispose to hemorrhage, it has not been clearly established that hemostatic defects are more common or more severe in bleeding than in nonbleeding patients with liver diesase. The many comprehensive reports of hemostasis in liver disease2-7 have not systematically related laboratory tests to clinical hemorrhage. Similarly, previous studies of hemostatic defects in patients with bleeding8-11 do not present comparable data on nonbleeding cirrhotics. Correlation between laboratory tests and clinical bleeding is further complicated by the difficulty in classifying minor degrees of hemorrhage.

In the present report hemostatic studies were performed on a consecutive series of patients with cirrhosis admitted to a medical ward and were correlated with the incidence of major hemorrhage, defined as bleeding sufficiently severe to require transfusion.