Interrelation between factor VII, prekallikrein, and hyperfibrinolysis in advanced cirrhosis

Factor VII and prekallikrein activities were studied in 37 patients with liver cirrhosis who were in a decompensated state. Sixteen of them died 30-70 days after admission; 21 survived and were discharged after 30-80 days. Seven who died and six survivors had signs of hyperfibrinolysis: factor VII a...

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Bibliographic Details
Published in:Journal of clinical pathology 1989-12, Vol.42 (12), p.1246-1249
Main Authors: Violi, F, Alessandri, C, Ferro, D, Saliola, M, Cordova, C, Musca, A, Balsano, F
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Bilirubin - blood
Biological and medical sciences
Blood Coagulation Disorders - complications
Factor VII - metabolism
Female
Fibrinolysis - physiology
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Liver Cirrhosis - blood
Liver Cirrhosis - complications
Liver Cirrhosis - mortality
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Prekallikrein - metabolism
Prognosis
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Summary:Factor VII and prekallikrein activities were studied in 37 patients with liver cirrhosis who were in a decompensated state. Sixteen of them died 30-70 days after admission; 21 survived and were discharged after 30-80 days. Seven who died and six survivors had signs of hyperfibrinolysis: factor VII activity differentiated the two groups independently of the presence of hyperfibrinolysis. The presence of hyperfibrinolysis significantly reduced prekallikrein activity, which did not differentiate clearly survivors from non-survivors. Long term follow up of survivors showed a good correlation between factor VII and prekallikrein activities with long term survival. Hyperfibrinolysis seemed to influence the clinical course of patients: 87% of patients with hyperfibrinolysis who died had fatal haemorrhagic episodes. Low factor VII activity may be a precursor of terminal liver insufficiency.
ISSN:0021-9746
1472-4146
DOI:10.1136/jcp.42.12.1246