Blood Coagulation Parameters in Patients with Chronic Liver Disease at a Teaching Hospital in Lagos

The liver is central to the synthesis of most coagulation factors, and chronic liver disease is associated with a complex coagulopathy characterized by both hypocoagulable and procoagulable states whose biochemical profiling is clinically essential. This study evaluates blood coagulation parameters in patients with chronic liver disease attending Lagos University Teaching Hospital. Seventy patients with confirmed chronic liver disease, including chronic viral hepatitis, liver cirrhosis, and alcoholic liver disease, staged by clinical assessment and abdominal ultrasonography, and forty healthy controls were enrolled. Coagulation studies included prothrombin time (PT) and international normalized ratio (INR), activated partial thromboplastin time (aPTT), thrombin time (TT), serum fibrinogen by the Clauss method, and platelet count. Liver synthetic function markers including serum albumin, total bilirubin, and ALT were concurrently determined. Results show significantly prolonged PT, INR, and aPTT in chronic liver disease patients compared to controls. INR exceeded 1.5 in 61 percent of patients, indicating clinically significant coagulopathy. Fibrinogen was significantly reduced in cirrhotic patients. Platelet count was significantly lower in cirrhotic patients, with thrombocytopenia present in 54 percent, reflecting hypersplenism. Patients with the most advanced liver disease as indicated by Child-Pugh Class C showed the most severe coagulation parameter abnormalities. Serum albumin correlated significantly and inversely with both PT and INR. The study provides evidence for comprehensive coagulation profiling as part of chronic liver disease management at Nigerian teaching hospitals. Keywords: coagulation parameters, chronic liver disease, prothrombin time, fibrinogen, Lagos.