ArticleLiver international : official journal of the International Association for the Study of the Liver2021
Coagulopathy is not predictive of bleeding in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 56 citations in OpenAlex.
- Bleeding and Thrombotic Risk in Cirrhosis: Hemostatic Profiles from a Single-Center Experience.Life (Basel, Switzerland) · 2026Article
- Viscoelastic testing: Transforming hemostasis management in patients in the medical intensive care unit.World journal of critical care medicine · 2026Review
- ROTEM-detected hypocoagulability is associated with major non-portal hypertensive bleeding in cirrhosis.Hepatology communications · 2026Article
- Thrombin dynamics and clinical events in cirrhosis: low prothrombin conversion predicts bleeding risk.Frontiers in cell and developmental biology · 2026Article
- Elevated FDP levels independently predict poor outcomes in HBV-ACLF patients treated with artificial liver support system therapy.Scientific reports · 2025Article
- Article
- Thrombotic Risk and Coagulation Imbalance in Cirrhosis and Hepatocellular Carcinoma: Clinical Implications and Management.Cancers · 2025Review
- Rethinking pre-procedural coagulation management in acute liver failure and acute-on-chronic liver failure: The emerging role of rotational thromboelastometry.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma.United European gastroenterology journal · 2025Article
- Beyond the Limits of Conventional Coagulation Tests: A Comprehensive Overview of ACLF-Related Coagulopathies.Journal of clinical medicine · 2025Review
- Prediction and prevention of post-procedural bleedings in patients with cirrhosis.Clinical and molecular hepatology · 2025Review
- Anticoagulants in cirrhosis: main concerns.Nature reviews. Gastroenterology & hepatology · 2024Article
- Acute decompensation of cirrhosis versus acute-on-chronic liver failure: What are the clinical implications?United European gastroenterology journal · 2024Review
- How to assess hemostasis in patients with severe liver disease.Hematology. American Society of Hematology. Education Program · 2023Article
- How to manage hemostasis in patients with liver disease during interventions.Hematology. American Society of Hematology. Education Program · 2023Review
- Pathophysiology and management of bleeding and thrombosis in patients with liver disease.International journal of laboratory hematology · 2022Review
- Global hemostatic profiling in patients with decompensated cirrhosis and bacterial infections.JHEP reports : innovation in hepatology · 2022Article
- Coagulopathy is not predictive of bleeding in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure.Liver international : official journal of the International Association for the Study of the Liver · 2021Article
- Recent Advances in the Management of Acute Variceal Hemorrhage.Journal of clinical medicine · 2021Review
- Serial rotational thromboelastometry measurements show worsening hypocoagulability in acute-on-chronic liver failure and are associated with the severity of liver disease.Annals of gastroenterologyArticle
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsUnderstanding factors responsible for the increased bleeding tendency in acute-on-chronic liver failure (ACLF) would improve the management of these complications. We investigated coagulation alterations in ACLF and assessed whether they were predictive of bleeding.
methodsCirrhosis patients with ACLF (cases) and acute decompensation (AD, controls) were prospectively recruited and underwent an extensive haemostatic assessment including standard tests, pro and anticoagulant factors, thrombomodulin-modified thrombin generation (TG) and thromboelastometry (ROTEM
resultsNinety-one patients were included (51 with ACLF, 40 with AD). Infections and ascites/renal dysfunction were the most common precipitating and decompensating events. Platelet count was lower while INR and activated partial thrombin time were longer in ACLF cohort vs AD. Regarding clotting factors, fibrinogen and factor VIII were comparable between groups while protein C and antithrombin were significantly reduced in ACLF. Endogenous thrombin potential by TG was comparable between groups. Clotting formation time and clot stability by ROTEM
conclusionWe found coagulation changes in ACLF to largely overlap with that of AD and evidence of preserved coagulation capacity in both groups. ROTEM alterations were indicative of a more pronounced hypocoagulable state in ACLF; however, no correlation was found between such alterations and bleeding.
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