Introduction
Red blood cell distribution width (RDW), is a routinely available parameter from complete blood counts, reflecting variability in erythrocyte size. Beyond its traditional hematological use, RDW has emerged as a potential prognostic marker in various systemic diseases, including chronic liver disease.
Aims & Methods
In this cross-sectional study, 200 cirrhotic patients with varying degrees of severity and etiologies were enrolled from a tertiary care hepatogastroenterology department. RDW was assessed in all patients, with a normal range set between 11% and 15%. Our aim is to assess the relationship between RDW values and cirrhosis severity, as evaluated by Child-Pugh scores and the Model for End-Stage Liver Disease (MELD). Statistical analyses included ANOVA, post-hoc Tukey tests, and Spearman correlation to determine the association between RDW and cirrhosis severity.
Results
Our study comprised 200 cirrhotic patients, 111 females and 89 males, with an average age of 58,06 ± 15.21 years (range: 19–95).The patients were distributed across different disease stages: 99 had Child-Pugh score A, 80 had Child-Pugh score B, and 21 had Child-Pugh score C.
ANOVA test was conducted to compare the mean RDW across the different Child-Pugh stages (A, B, and C). The analysis revealed a statistically significant difference between the 3 groups: A (15,83), B (17,02), C (18,04)(p < 0.001). Tukey's post-hoc test showed that: Stage C had a significantly higher RDW compared to stages A (p = 0.020) and B (p = 0.020). These results suggest a progressive increase in RDW with worsening severity of liver disease.
Among patients classified as Child A, only 36.4% exhibited a high RDW, while in groups Child B and Child C, higher rates of RDW were observed, reaching 68.7% and 87.5% respectively. A significant positive correlation was found between the Child-Pugh stage and the RDW (p < 0.001), as assessed by Spearman’s correlation test. Similarly, a significant positive correlation was found between the MELD score and the RDW (p < 0.001). This finding suggests that patients with more advanced liver disease, tend to exhibit greater anisocytosis, possibly reflecting underlying inflammation, nutritional deficiencies, or bone marrow stress.
Conclusion
In conclusion, our findings suggest that RDW tends to rise with the progression of hepatic dysfunction, underscoring its potential as a simple and accessible biomarker for assessing disease severity in patients with cirrhosis. Nonetheless, further studies are needed to comprehensively evaluate the utility of RDW as a reliable predictor of cirrhosis severity.