Chinese Hepatolgy ›› 2024, Vol. 29 ›› Issue (10): 1239-1242.

• Liver Fibrosis & Cirrhosis • Previous Articles     Next Articles

Effectiveness of thromboelastogram clot formation time (K value) and maximum amplitude in predicting bleeding after central vein catheterization in patients with hepatitis B cirrhosis

ZHANG Li, WANG Meng-jie, SUN Meng-qiu   

  1. 1. Department of Blood transfusion, Xuzhou Central Hospital, Jiangsu 221000, China;
    2. Department of Blood Transfusion,Lianyungang First People's Hospital/Xuzhou Medical University Affiliated Lianyungang Hospital, Jiangsu 222000, China
  • Received:2023-09-26 Online:2024-10-31 Published:2024-12-02
  • Contact: SUN Meng-qiu,Email:18168779345@163.com

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Abstract: Objective To explore the effectiveness of predicting bleeding events after central venous catheterization in patients with hepatitis B cirrhosis by using thromboelastogram (TEG) clot formation time (K value) and maximum amplitude (MA). Methods The clinical data of 166 patients with hepatitis B cirrhosis who underwent central venous catheterization between May 2021 and May 2022 at Xuzhou Central Hospital were retrospectively analyzed. They were divided into bleeding group (n=45) and non-bleeding group (n=121) according to whether there was bleeding after surgery. All patients were tested by TEG, and univariate analysis was conducted for each index. The statistically significant variables in the univariate analysis were included in the multiple logistic regression analysis, so as to screen out the risk factors predicting the bleeding after central vein catheterization for hepatitis B cirrhosis. The value of each risk factor to predict the bleeding after central vein catheterization for patients with hepatitis B cirrhosis was analyzed using the receiver operating characteristic curve (ROC). Results The results of univariate analysis showed that there were statistically significant differences in coagulation time (K), international normalized ratio (INR) and MA between the two groups (P<0.05). Multivariate Logistic regression analysis showed that K time ≥3.05 min and INR≥2.6 were the risk factors for bleeding after central venous catheterization in patients with hepatitis B cirrhosis (OR=5.613 and 5.703, P<0.05), and MA≥48.8 mm was the protective factor for bleeding after central venous catheterization in patients with hepatitis B cirrhosis (OR=0.874, P<0.05). ROC curve analysis showed that the area under the curve of K, MA, INR to predict the bleeding after central vein catheterization is 0.878, 0.858, 0.854 respectively, with a good prediction efficiency. Conclusion TEG blood clot formation time (K value) and MA have a high value in predicting the bleeding after central vein catheterization in patoents with hepatitis B cirrhosis. K time ≥ 3.05 min and INR ≥ 2.6 are risk factors, and MA ≥48.8 mm was the protective factor for bleeding after central vein catheterization in hepatitis B cirrhosis patients.

Key words: Cirrhosis, Thromboelastogram, Central venous catheterization, Bleeding event