A prospective study of conventional and expanded coagulation indices in predicting ulcer bleeding after variceal band ligation.

BACKGROUND & AIMS: There is controversy over whether coagulation status predicts bleeding caused by ulceration after esophageal varices band ligation (EVL). METHODS: EVL was performed for primary (n = 45) or secondary (n = 105) prophylaxis in 150 patients with cirrhosis (Child A, n = 74, 49%; Child B, n = 42, 28%; Child C, n = 34, 23%). International normalized ratio (INR) and platelet counts were assessed in all. In 92 patients, levels of factor V, fibrinogen, D-dimer, protein C and protein S, von Willebrand factor, and thromboelastography (TEG) were assessed. Platelet count <50 x 10(3)/mm(3) and INR >1.5 were considered high-risk cutoff for bleeding. Conversely, platelet count >or=50 x 10(3)/mm(3) with INR