Abstract
This study aimed to evaluate the appropriateness of terlipressin use and assess its effects on coagulation parameters in 240 hospitalized patients treated between January 2024 and January 2025 in a real-world, single-center retrospective cohort. Clinical appropriateness, encompassing diagnostic indication, initial dosing, and administration route, was rigorously evaluated against current clinical guidelines and the manufacturer's prescribing information. Key coagulation parameters - prothrombin time, thrombin time, activated partial thromboplastin time, and fibrinogen - were analyzed before and after treatment using paired-sample t tests, and patients were stratified into short-course (≤5 days) and long-course (≥6 days) therapy groups to examine the impact of treatment duration on outcomes using independent-sample t tests. The analysis revealed a high degree of appropriateness: 231 patients (96.3%) received terlipressin for guideline-consistent indications, 143 patients (59.6%) were administered the recommended initial bolus dose of 2 mg, and 185 cases (77.1%) employed the advised slow intravenous infusion route. Treatment with terlipressin significantly improved coagulation, with prothrombin time decreasing by a mean of 1.43 seconds and fibrinogen increasing by 0.11 g/L (both P < .01). However, extending the treatment course beyond 5 days offered no additional coagulation benefit, as no parameters showed significant improvement in the long-course compared with the short-course group (all P > .05). These results underscore that terlipressin use was largely appropriate for indication and route, but extending therapy beyond 5 days provided no additional coagulation benefit. This finding supports stricter adherence to guideline-recommended treatment duration to promote more rational and effective use of terlipressin in clinical practice.