Bleeding predictors in factor-XI-deficient patients

Blood Coagul Fibrinolysis. 1997 Nov;8(8):511-5. doi: 10.1097/00001721-199711000-00005.

Abstract

Bleeding in factor-XI-deficient patients is mainly injury-related. Parameters influencing bleeding particularly in patients with minor factor XI deficiency have not been defined. We utilized a logistic regression model to analyze parameters influencing bleeding tendency in subjects from 45 families with factor XI deficiency. Bleeding manifestations were documented in 58% of 26 homozygous or doubly heterozygous factor-XI-deficient patients, in 20% of 46 heterozygous factor-XI-deficient patients and in 9% of 47 family members with a normal factor XI genotype. Odds ratios for bleeding in homozygotes or double heterozygotes were 13 and in heterozygotes 2.6 with 95% confidence intervals of 3.8-45 and 0.8-9.0, respectively. Bleeding correlated negatively with factor XI level (r = -0.36, P = 0.0001) with major factor XI deficiency being a strong predictor of bleeding (P = 0.011). Minor factor XI deficiency and blood group O slightly contributed to bleeding. Although factor VIII and factor XI levels were correlated (r = 0.48, P = 0.0001), levels of factor VIII and von Willebrand factor were not predictors of bleeding. Bleeding was more common following operative procedure involving mucosal membranes (P < 0.01). The designed model enabled prediction of bleeding manifestations with an overall accuracy of 78% and 82% in heterozygotes.

MeSH terms

  • Case-Control Studies
  • Factor VIII / metabolism
  • Factor XI / genetics
  • Factor XI / metabolism
  • Factor XI Deficiency / complications*
  • Genotype
  • Hemorrhage / diagnosis*
  • Hemorrhage / etiology
  • Humans
  • Logistic Models
  • Predictive Value of Tests
  • Regression Analysis
  • von Willebrand Factor / metabolism

Substances

  • von Willebrand Factor
  • Factor VIII
  • Factor XI