Plasma Clotting Factors in Chronic Hepatocellular Disease

The experience of caring for a cirrhotic patient whose prothrombin time was only moderately prolonged but who bled profusely after tooth extraction prompted us to compare prothrombin times with more specific clotting-factor assays in a group of patients with chronic hepatocellular disease (primarily Laënnec's cirrhosis). We wished to learn if prothrombin times fully reflect the severity of the individual clotting-factor defects that arise in such patients and, secondly, if these defects are severe enough to account for the great difficulty frequently encountered in stopping gastrointestinal bleeding in cirrhotic patipatients.MethodsThe Quick test, the prothrombin-proconvertin (P and P) test, the . . .