Liver Disease

LIVER DISEASE

A 65-year-old woman presented for open reduction internal fixation (ORIF) of a hip fracture, sustained during an accidental fall. Past medical history was significant for hepatitis C cirrhosis and heavy alcohol use. Cirrhosis developed after a blood transfusion received during gynecologic surgery approximately 15 years previously. She denied extrahepatic problems from liver disease such as variceal bleeding or encephalopathy. On physical examina-tion, she weighed 55 kg and stood 152 cm tall. She was nonicteric and had minimal ascites. Selected laboratory examinations included a hematocrit of 34% after intra-venous hydration, normal transaminase levels, and an albumin level of 3.2 g/dL. Her prothrombin time (PT) was 16 seconds over a control of 14 seconds, and platelet count was 90,000/mm³.