The role of coagulation waveform kinetic parameters in the early diagnosis and prognosis of coagulopathy in hepatitis and cirrhosis.

BACKGROUND: To evaluate the clinical relevance of coagulation waveform analysis (CWA) kinetic parameters in the early detection, severity assessment, and prognosis of coagulopathy in patients with hepatitis and cirrhosis. METHODS: Real-time CWA was performed alongside conventional coagulation tests (PT, APTT, TT, FIB). CWA kinetic parameters, including maximum velocity (Min1), acceleration (Min2), deceleration (Max2), and maximum clot density (Delta), were derived mathematically. RESULTS: CWA parameters detected early coagulopathy more sensitively than conventional assays. In the Child-Turcotte-Pugh (CTP)-A stage, PT-Min1 decreased significantly by 19.1% compared to controls, whereas conventional PT prolonged by only 4.5%. PT-Min1 correlated negatively with CTP class (r = -0.533, P < 0.001) and served as a sensitive early warning indicator, alongside the conventional PT's association with disease severity (r = -0.666, P < 0.001). CONCLUSION: PT-Min1 is a highly sensitive, early indicator of coagulopathy in hepatitis and cirrhosis. It detects significant hemostatic alterations during the CTP-A stage before substantial changes in conventional tests occur, facilitating earlier clinical intervention.