Prognostic Relevance of Anemia In Hospitalized Patients With Cirrhosis:A Multicenter Cohort Study

Abstract

Background and Aims: Anemia is common in cirrhosis and closely related with adverse outcome in cirrhotic patients, but their clinical features and the effect of variations in hemoglobin levels on mortality or time of death have not yet fully elucidated. As we performed this prospective, multi-center, cohort study to further determine these points.Methods: We retrospectively collected data from the Chinese AcuTe on CHronic LIver FailurE (CATCH-LIFE) study, a prospective multi-center cohort study of patients with chronic liver disease and acute exacerbation conducted by the Chinese Chronic Liver Failure (CLIF) Consortium, which is composed of 15 tertiary hospitals in hepatitis-B-virus high endemic area. Patients were consisted of two prospective multi-center cohorts from the CLIF Consortium between January 2015 to December 2016 and July 2018 to January 2019.We conducted data analysis on prevalence of anemia and clinical characteristics among these patients and further determine the relationship between anemia and prognosis.Results: Among 1979 hospitalized patients with cirrhosis,1389(70.2%) were combine with anemia, a patient has an 6.8% lower risk of death on 90-day mortality and 5.7% lower risk of death on 1-year mortality with a 10g/L decrease in hemoglobin at any level throughout the entire range. Patients with severe anemia have significant higher risk [HR=1.649(1.100,2.473), p=0.016] of 90-day mortality and [HR=1.610(1.159,2.238), p=0.005] of 1-year mortality comparedto those without anemia.Conclusions: Anemia is common in cirrhosis and strongly associated with increased mortality after acute decompensation (AD)/acute liver injury (ALI). Severe anemia is an independent risk factor for poor 90-day and 1-year prognosis in cirrhosis with AD/ALI.