Abstract
OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.
| Original language | English |
|---|---|
| Pages (from-to) | 368-375 |
| Number of pages | 8 |
| Journal | American Journal of Gastroenterology |
| Volume | 113 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2018 |
Fingerprint
ASJC Scopus subject areas
- Hepatology
- Gastroenterology
Cite this
Platelet count does not predict bleeding in cirrhotic patients : Results from the PRO-LIVER Study. / PRO-LIVER Collaborators.
In: American Journal of Gastroenterology, Vol. 113, No. 3, 01.03.2018, p. 368-375.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Platelet count does not predict bleeding in cirrhotic patients
T2 - Results from the PRO-LIVER Study
AU - PRO-LIVER Collaborators
AU - Basili, S.
AU - Raparelli, V.
AU - Napoleone, L.
AU - Talerico, G.
AU - Corazza, G. R.
AU - Perticone, F.
AU - Sacerdoti, D.
AU - Andriulli, A.
AU - Licata, A.
AU - Pietrangelo, A.
AU - Picardi, A.
AU - Raimondo, G.
AU - Violi, F.
AU - Palasciano, Giuseppe
AU - D’Alitto, Felicia
AU - Palmieri, Vincenzo Ostilio
AU - Santovito, Daniela
AU - Di Michele, Dario
AU - Croce, Giuseppe
AU - Brocco, Silvia
AU - Fasolato, Silvano
AU - Cecchetto, Lara
AU - Bombonato, Giancarlo
AU - Bertoni, Michele
AU - Restuccia, Tea
AU - Andreozzi, Paola
AU - Liguori, Maria Livia
AU - Caroleo, Benedetto
AU - Perticone, Maria
AU - Staltari, Orietta
AU - Marinelli, Sara
AU - Ippolito, Antonio
AU - Iacobellis, Angelo
AU - Niro, Grazia
AU - Merla, Antonio
AU - Pinto, Antonio
AU - Greco, Antonio
AU - Invernizzi, Pietro
AU - Forgione, Alessandra
AU - Giannelli, Gianluigi
AU - Rizzetto, Mario
AU - Bergamaschi, Gaetano
AU - Gobbi, Paolo
AU - Costantino, Giorgio
AU - Bianchi, Paola Ilaria
AU - Bracco, Christian
AU - Carrabba Maria, Domenica
AU - Colombo, Barbara Maria
AU - Marchese, Alessandra
AU - Pinna, Miriam
PY - 2018/3/1
Y1 - 2018/3/1
N2 - OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.
AB - OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.
UR - http://www.scopus.com/inward/record.url?scp=85043697833&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85043697833&partnerID=8YFLogxK
U2 - 10.1038/ajg.2017.457
DO - 10.1038/ajg.2017.457
M3 - Article
AN - SCOPUS:85043697833
VL - 113
SP - 368
EP - 375
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 3
ER -