PWE-155 The Safety of Ascitic Drain Insertion in Patients with Deranged Coagulation

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Abstract

Introduction

Abdominal paracentesis for ascites is not an uncommonly performed procedure. Most patients needing abdominal paracentesis have significant derangement of coagulation. We wanted to assess the safety of abdominal paracentesis in patients with significant INR elevation.

Methods

67 consecutive patients requiring abdominal paracentesis at our hospital were retrospectively analysed. Patients were placed in to 3 groups depending on the baseline INR (Group A: INR 1–1.4, Group B: INR 1.5–1.9, Group C: INR 1.9 and above). Complication data collected on all patients using a standarised profroma. All data was then entered on to a spreadsheet program (Microsoft Excel) and analysed using SPSS v22.

Results

Of the 67 patients 25 (37%) had a near normal INR (group A), 32 (48%) had moderate INR prolongation and 10 (15%) had significant INR prolongation (group C). 3 patients in group C received fresh frozen plasma (FFP). Overall there was no significant increase in the frequency of Blood staining, Hypotension, Leaking drain site, Infection, Peritonitis, Perforation and Death across all 3 groups (full data and p values shown in Table 1).

Conclusion

The complication rate does not significantly increase with increasingly deranged coagulation. This is despite very low usage of FFP in this study. There is a trend towards an increased risk of bloodstaining and hypotension in the high INR group, which does not achieve statistical significance.

Disclosure of Interest

None Declared.

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