Comparison of the serum fibrinogen level and International Normalized Ratio in the assessment of coagulopathy in decompensated cirrhosis at Imam Reza Hospital of Tabriz

Abstract

In the present study, we aimed to assess the relationship between coagulation abnormalities and the risk of GI bleeding using INR, platelet count, and plasma fibrinogen level in cirrhotic patients. Material and Methods: Seventy-eight cirrhotic patients were enrolled in this study. We assessed demographic, biochemical, hematologic (platelet count) 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. Patients were asked for the history of bleeding episodes within 6 months before inclusion. A blood sample was drowned and fibrinogen and prothrombin time (PT) were measured and International normalized ratio (INR) was calculated. Results: The patients' mean age was 51.23±15.08 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). According to the result of the ROC curve, the fibrinogen level was a better predictive marker of bleeding in cirrhotic patients (AUC: 0.87). According to the results of predictive tests, fibrinogen level had sensitivity of (77%) and specificity of (%94) in the prediction of bleeding with the cut-off value of 182.5.