TP-24 : Thematic Poster ; Bleeding Complications in Critically Ill Patients with Liver Cirrhosis = TP-24 : Thematic Poster ; Bleeding Complications in Critically Ill Patients with Liver Cirrhosis

다국어 초록 (Multilingual Abstract)

Objective: Patients with liver cirrhosis (LC) are prone to critical events leading to intensive care unit (ICU) admission. Coagulopathy in cirrhotic patients is complex and can lead to bleeding as well as to thrombosis. The aim of this study was to investigate bleeding complications of critically ill patients with LC admitted to the medical ICU (MICU). Methods: All adult patients admitted to the MICU with a diagnosis of LC from January 2006 to December 2012 were retrospectively assessed. Patients with major bleeding at MICU admission were excluded. Results: Total of 205 patients was included for analysis. The median age of the patients was 62 years and 69.3% of the patients were male. The most common reason for ICU admission was acute respiratory failure (45.4%) followed by sepsis (27.3%). Major bleeding occurred in 25 patients (12.2%). Gastrointestinal bleeding (64.0%) was the most common site of bleeding followed by respiratory tract bleeding (20.0%). Platelet count was significantly lower in the group with major bleeding (median, 41.0 vs. 76.5×109 cells/L, respectively; P=0.035) and low platelet count was the single independent risk factor for bleeding (OR, 0.988; 95% CI, 0.978-0.999). The ICU mortality was significantly higher in patients with major bleeding (84.0% vs. 58.9%, respectively; P=0.015) and bleeding-attributable ICU mortality rate was 50%. Conclusion: Low platelet count is associated with an increased risk of major bleeding in critically ill patients with LC. Further studies are needed for proper understanding of hemostasis in these patients. Objective: Patients with liver cirrhosis (LC) are prone to critical events leading to intensive care unit (ICU) admission. Coagulopathy in cirrhotic patients is complex and can lead to bleeding as well as to thrombosis. The aim of this study was to investigate bleeding complications of critically ill patients with LC admitted to the medical ICU (MICU). Methods: All adult patients admitted to the MICU with a diagnosis of LC from January 2006 to December 2012 were retrospectively assessed. Patients with major bleeding at MICU admission were excluded. Results: Total of 205 patients was included for analysis. The median age of the patients was 62 years and 69.3% of the patients were male. The most common reason for ICU admission was acute respiratory failure (45.4%) followed by sepsis (27.3%). Major bleeding occurred in 25 patients (12.2%). Gastrointestinal bleeding (64.0%) was the most common site of bleeding followed by respiratory tract bleeding (20.0%). Platelet count was significantly lower in the group with major bleeding (median, 41.0 vs. 76.5×109 cells/L, respectively; P=0.035) and low platelet count was the single independent risk factor for bleeding (OR, 0.988; 95% CI, 0.978-0.999). The ICU mortality was significantly higher in patients with major bleeding (84.0% vs. 58.9%, respectively; P=0.015) and bleeding-attributable ICU mortality rate was 50%. Conclusion: Low platelet count is associated with an increased risk of major bleeding in critically ill patients with LC. Further studies are needed for proper understanding of hemostasis in these patients.