Coagulation Pathologies in Patients With Chronic Liver Disease at a Tertiary Care Hospital, Peshawar

Abstract

Background: Chronic liver disease (CLD) disrupts hemostasis through impaired hepatic synthesis of coagulation factors and thrombopoietic dysfunction, producing laboratory abnormalities such as prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombocytopenia that complicate clinical assessment in resource-limited settings. Objective: To determine the frequency of laboratory-defined coagulopathy among adults with CLD and evaluate its association with age, gender, and body mass index (BMI). Methods: This descriptive cross-sectional study was conducted at Hayatabad Medical Complex, Peshawar, from 16 November 2021 to 16 May 2022. A total of 174 patients aged 40–60 years with CLD of ≥6 months’ duration were enrolled by consecutive sampling. PT, aPTT, and platelet count were measured using standardized laboratory methods. Coagulopathy was defined as prolonged PT and/or prolonged aPTT (above the institutional upper reference limit) and/or thrombocytopenia (<150,000/µL). Associations were assessed using chi-square or Fisher’s exact tests with odds ratios (OR) and 95% confidence intervals (CI). Results: Coagulopathy was present in 112/174 patients (64.4%; 95% CI: 57.3–71.5). Prevalence was higher in BMI ≥30 kg/m² versus <30 kg/m² (75.0% vs 58.8%; OR 2.10; 95% CI: 1.03–4.29; p=0.03). Coagulopathy occurred in 56/78 (71.8%) aged 40–50 years and 56/96 (58.3%) aged 51–60 years (OR 1.82; 95% CI: 0.94–3.51; p=0.06). All males had coagulopathy (94/94, 100.0%) compared with 18/80 females (22.5%; Fisher’s exact p<0.001). Conclusion: Laboratory-defined coagulation abnormalities were highly prevalent in CLD, with significant associations observed for male gender and obesity, supporting routine screening with PT, aPTT, and platelet count for risk stratification in tertiary-care practice.