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Clinical and Applied Thrombosis/Hemostasis
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Patterns of Acquired Bleeding Disorders in a Tertiary Care Hospital

Bhushan Asthana, MD, DNB

All India Institute of Medical Sciences, New Delhi India

Prashant Sharma, MD, DNB

All India Institute of Medical Sciences, New Delhi India

Ravi Ranjan, MSc

All India Institute of Medical Sciences, New Delhi India

Prachi Jain, MBBS

All India Institute of Medical Sciences, New Delhi India

Ajisha Aravindan, MBBS

All India Institute of Medical Sciences, New Delhi India

Pravas Chandra Mishra, MD, DM

All India Institute of Medical Sciences, New Delhi India

Renu Saxena, MD

All India Institute of Medical Sciences, New Delhi India, renusax{at}hotmail.com

Bleeding disorders constitute a large proportion of referrals to hematology departments. Worldwide, acquired causes of bleeding are commoner than inherited ones. To identify the spectrum of these disorders, we evaluated all referrals for bleeding encountered in this tertiary care centre over a one-year period. Of the total 1342 cases, 1040 (77.5%) had underlying exclusively acquired causes, whereas inherited causes constituted 302 cases (22.5%). Amongst acquired causes, disseminated intravascular coagulation was seen in 297 (28.6%), hepatic coagulopathy in 218 (20.9%), neurosurgical causes (intracranial bleeds) in 154 (14.8%), malignancy in 89 (8.6%), and miscellaneous multiple acquired causes including those due to anticoagulant drug overdose in 282 patients (27.1%). Referrals for isolated prolonged prothrombin time or thrombocytopenia were common, but were excluded from this study because not all presented with bleeding. Prompt laboratory work-up and precise identification of acquired causes of bleeding is the key to planning appropriate patient management including transfusion support.

Key Words: acquired bleeding disorders • DIC • hepatic coagulopathy • isolated prolonged prothrombin time • factor inhibitors • hemostasis • anticoagulants

This version was published on August 1, 2009

Clinical and Applied Thrombosis/Hemostasis, Vol. 15, No. 4, 448-453 (2009)
DOI: 10.1177/1076029609334123
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