CASE-CONTROLLED STUDY OF ACUTE NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING-INDUCED COAGULATION DYSFUNCTION

Ya Zhang^1#, Yu Zhang^2#, Qi Liu^1*, Hong Yang¹, Xian Cao³

1Department of Gastroenterology, the Affiliated Hospital of Guizhou Medical University, the Affiliated Jingyang Hospital of Guizhou Medical University, Guiyang 550004, China - ²Department of Digestive Nephropathy, Longshan People's Hospital of Hunan Province, Xiangxi Tujia and Miao Autonomous Prefecture 416800, China - ³Department of Gastroenterology and Hepatobiliary, the Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550058, China

Objective: To investigate whether coagulation dysfunction exists in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB) and whether there may be any change in the coagulation function when the Rockall scores are different.

Methods: A total of 364 ANVUGIB patients were selected and divided into the high-risk group (≥5 points, H), the intermediate-risk group (3-4 points, I), and thelow-risk group (0-2 points, L) according to the Rockall scores. The coagulation/fibrinolysis markers were detected in all participants, together with healthy controls selected during the same period.

Results: In general, the differences in prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (D-D), and Ca²⁺ between ANVUGIB patients and healthy controls were statistically significant (P<0.05). There was statistical significance in PT, INR, APTT, and Ca²⁺ among the groups with different Rockall scores (P<0.05). There was a negative correlation between Ca²⁺ and Rockall score in group L (P<0.05, r=-0.196) while a positive correlation between D-D and Rockall score in group H (P<0.05, r=0.509).

Conclusions: PT, INR, APTT, FIB, D-D, and Ca²⁺, which are commonly used in laboratory, can be used as effective markers for the diagnosis and treatment of patients with ANVUGIB-caused coagulopathy.