UNVEILING THE LINK: EXPLORING THE IMPACT OF ANAEMIA ON THE SEVERITY OF CHRONIC LIVER DISEASE IN PATIENTS AT A TERTIARY CARE HOSPITAL

Rajesh Sharma; Richa Sharma; Remya S R

doi:10.55489/njmr.13022023960

Authors

Rajesh Sharma Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
Richa Sharma Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh
Remya S R Saraswathi Institute of Medical Sciences Hapur, Uttar Pradesh

DOI:

https://doi.org/10.55489/njmr.13022023960

Keywords:

haemoglobin, Chronic liver disease (CLD), Child Pugh score, CPS, Meld score

Abstract

Introduction: Despite the clinical relevance and potential implications of anaemia in CLD, the available evidence regarding the association between anaemia and the severity of liver disease remains inconsistent and limited.

Method: A cross sectional study was done among 116 CLD patients to address this research gap by investigating the prevalence, Etiology, and clinical implications of anemia among patients with CLD.

Result: Out of total 116 patients, 57.8% had anemia. Among patients with anaemia, there were 56 males and 11 females. 71.2% (48) had mild anaemia, compared to 20.1% (14) and 20.1% (14) who had moderate and severe anaemia, respectively. 31 out of 67 (46.3%) were classified as CPS A and CPS B, and only 5 (7.4%) were classified as CPS C. When comparing patients with and without anaemia, the mean MELD points were 12.1 and 9.5, respectively.

Conclusion: there was association found between anaemia and the severity of chronic liver disease, as indicated by higher MELD, and a higher proportion of patients in the more severe Child-Pugh scores categories with anaemia.

References

1. Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol [Internet]. 2019 Jan 1 [cited 2023 Jun 19];70(1):151-71. Doi: https://doi.org/10.1016/j.jhep.2018.09.014 PMid:30266282

2. Cheemerla S, Balakrishnan M. Global Epidemiology of Chronic Liver Disease. Clin Liver Dis (Hoboken) [Internet]. 2021 May 1 [cited 2023 Jun 19];17(5):365. Doi: https://doi.org/10.1002/cld.1061 PMid:34136143 PMCid:PMC8177826

3. Scheiner B, Semmler G, Maurer F, Schwabl P, Bucsics TA, Paternostro R, et al. Prevalence of and risk factors for anaemia in patients with advanced chronic liver disease. Liver International [Internet]. 2020 Jan 1 [cited 2023 Jun 19];40(1):194. Doi: https://doi.org/10.1111/liv.14229 PMid:31444993 PMCid:PMC6973120

4. Turner J, Parsi M, Badireddy M. Anemia. Preoperative Assessment: A Case-Based Approach [Internet]. 2022 Aug 8 [cited 2023 Jun 20];263-6. Doi: https://doi.org/10.1007/978-3-030-58842-7_41

5. Maruyama S, Hirayama C, Yamamoto S, Koda M, Udagawa A, Kadowaki Y, et al. Red blood cell status in alcoholic and non-alcoholic liver disease. J Lab Clin Med [Internet]. 2001 [cited 2023 Jun 20];138(5):332-7. Doi: https://doi.org/10.1067/mlc.2001.119106 PMid:11709657

6. Qamar AA, Grace ND, Groszmann RJ, Garcia-Tsao G, Bosch J, Burroughs AK, et al. Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compen-sated Cirrhosis. Clin Gastroenterol Hepatol [Internet]. 2009 Jun [cited 2023 Jun 20];7(6):689. Doi: https://doi.org/10.1016/j.cgh.2009.02.021 PMid:19281860 PMCid:PMC4545534

7. Kalaitzakis E, Josefsson A, Castedal M, Henfridsson P, Bengtsson M, Andersson B, et al. Hepatic encephalopathy is related to anemia and fat-free mass depletion in liver transplant candidates with cirrhosis. Scand J Gastroenterol [Internet]. 2013 May [cited 2023 Jun 20];48(5):577-84. Doi: https://doi.org/10.3109/00365521.2013.777468 PMid:23452072

8. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W, Shuhart MC, Davis GL, et al. Prevention and management of gas-troesophageal varices and variceal hemorrhage in cirrhosis. Hepatology [Internet]. 2007 [cited 2023 Jun 20];46(3):922-38. Doi: https://doi.org/10.1002/hep.21907 PMid:17879356

9. Gonzalez-Casas R, Jones EA, Moreno-Otero R. Spectrum of anemia associated with chronic liver disease. World J Gastroenterol. 2009;15(37):4653-8. Doi: https://doi.org/10.3748/wjg.15.4653 PMid:19787828 PMCid:PMC2754513

10. Møller S, Henriksen JH, Bendtsen F. Extrahepatic complications to cirrhosis and portal hypertension: Haemodynamic and homeostatic aspects. World Journal of Gastroenterology: WJG [Internet]. 2014 Nov 11 [cited 2023 Jun 20];20(42):15499. Doi: https://doi.org/10.3748/wjg.v20.i42.15499 PMid:25400435 PMCid:PMC4229516

11. Ministry of Health and Family Welfare. Anemia Mukt Bharat: Press Information Bureau [Internet]. [cited 2023 May 29].

12. Sayaf K, Gabbia D, Russo FP, De Martin S. The Role of Sex in Acute and Chronic Liver Damage. Int J Mol Sci [Inter-net]. 2022 Sep 1 [cited 2023 Jun 21];23(18):10654. Doi: https://doi.org/10.3390/ijms231810654 PMid:36142565 PMCid:PMC9505609

13. Burns GS, Thompson AJ. Viral Hepatitis B: Clinical and Epidemiological Characteristics. Cold Spring Harb Perspect Med [Internet]. 2014 [cited 2023 Jun 21];4(12). Doi: https://doi.org/10.1101/cshperspect.a024935 PMid:25359547 PMCid:PMC4292086

14. Rai V, Dhameja N, Kumar S, Shukla J, Singh R, Dixit VK. Haemostatic Profile of Patients with Chronic Liver Disease- its Correlation with Severity and Outcome. J Clin Diagn Res [Internet]. 2017 Aug 1 [cited 2023 Jun 21];11(8):EC24.

15. Chalasani N, Horlander JC, Said A, Hoen H, Kopecky KK, Stockberger SM, et al. Screening for hepatocellular carci-noma in patients with advanced cirrhosis. Am J Gastroen-terol [Internet]. 1999 [cited 2023 Jun 21];94(10):2988-93. Doi: https://doi.org/10.1111/j.1572-0241.1999.01448.x PMid:10520857

16. Gonzalez-Casas R, Garcia-Buey L, Jones EA, Gisbert JP, Moreno-Otero R. Systematic review: hepatitis-associated aplastic anaemia--a syndrome associated with abnormal immunological function. Aliment Pharmacol Ther [Inter-net]. 2009 Sep [cited 2023 Jun 21];30(5):436-43. Doi: https://doi.org/10.1111/j.1365-2036.2009.04060.x PMid:19508613

17. Singh S, Manrai M, Parvathi VS, Kumar D, Srivastava S, Pathak B. Association of liver cirrhosis severity with ane-mia: does it matter? Ann Gastroenterol [Internet]. 2020 May 9 [cited 2023 Jun 21];33(3):272. Available from: /pmc/articles/PMC7196620/