Coagulation Abnormalities Associated With Chronic Liver Disease

Muhammad Noman; Zubair Ahmad Rana; Zainab Rizwan; Muhammad Ahmad

doi:10.54112/bcsrj.v7i6.2344

Authors

Muhammad Noman Department of Medical Laboratory Sciences, Faculty of Allied Health & Medicine, The University of Faisalabad, (TUF), Punjab, Pakistan
Zubair Ahmad Rana Department of Medical Laboratory Sciences, Faculty of Allied Health & Medicine, The University of Faisalabad, (TUF), Punjab, Pakistan
Zainab Rizwan Department of Medical Laboratory Sciences, Faculty of Allied Health & Medicine, The University of Faisalabad, (TUF), Punjab, Pakistan
Muhammad Ahmad Department of Medical Laboratory Sciences, Faculty of Allied Health & Medicine, The University of Faisalabad, (TUF), Punjab, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v7i6.2344

Keywords:

Chronic liver disease; Coagulation abnormalities; Thrombocytopenia; Prothrombin time; International normalized ratio; MELD score

Abstract

Chronic liver disease is frequently associated with hematological and coagulation abnormalities due to impaired hepatic synthetic function, thrombocytopenia, hypersplenism, and altered hemostatic balance. Routine parameters such as platelet count, prothrombin time, activated partial thromboplastin time, and international normalized ratio remain widely used for clinical assessment. Objective: To evaluate the frequency and pattern of coagulation abnormalities in patients with chronic liver disease and to determine their correlation with Child-Pugh and MELD scores. Methods: This cross-sectional analytical study was conducted from January 2026 to April 2026 at Shifa International Hospital and Madina Teaching Hospital, Faisalabad. A total of 152 participants were included, comprising 120 patients with chronic liver disease and 32 healthy controls. Complete blood count, platelet count, prothrombin time, activated partial thromboplastin time, and international normalized ratio were measured. Disease severity was assessed using Child-Pugh and MELD scores. Data were analyzed using SPSS version 24, and a p-value <0.05 was considered statistically significant. Results: The mean age of participants was 50.00 ± 8.72 years, and 58.6% were male. Patients with chronic liver disease had significantly lower hemoglobin levels and platelet counts compared with controls. They also showed significantly prolonged prothrombin time, prolonged activated partial thromboplastin time, and elevated international normalized ratio values. Thrombocytopenia was the most frequent abnormality, present in 79.0% of chronic liver disease patients, followed by elevated INR in 76.5%, anemia in 74.0%, prolonged PT in 72.3%, and prolonged aPTT in 66.4%. PT, aPTT, and INR showed significant positive correlations with Child-Pugh and MELD scores, while platelet count and hemoglobin showed significant inverse correlations with coagulation derangement. Conclusion: Coagulation and hematological abnormalities are highly frequent among patients with chronic liver disease and are significantly associated with increasing disease severity. Thrombocytopenia, elevated INR, prolonged PT, prolonged aPTT, and anemia may serve as useful routine markers for clinical assessment and risk stratification in chronic liver disease.

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