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P17 Is red cell distribution width (RCDW) a useful prognostic tool in alcoholic hepatitis?

Gut, 2023-09, Vol.72 (Suppl 3), p.A23-A23 [Peer Reviewed Journal]

2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0017-5749 ;EISSN: 1468-3288 ;DOI: 10.1136/gutjnl-2023-BASL.33

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  • Title:
    P17 Is red cell distribution width (RCDW) a useful prognostic tool in alcoholic hepatitis?
  • Author: Khan, Reenam ; Shees Salman ; Harford, Laura ; Sheriff, Lozan ; Hazeldine, John ; Rajoriya, Neil ; Newsome, Phil ; Lalor, Patricia
  • Subjects: Cirrhosis ; Drinking behavior ; Hepatitis ; Infections ; Liver cirrhosis ; Liver diseases ; Mortality
  • Is Part Of: Gut, 2023-09, Vol.72 (Suppl 3), p.A23-A23
  • Description: Mortality from alcohol-related liver disease (ALD) continues to rise and alcoholic hepatitis (AH) the acute inflammatory form of ALD is of particular concern. Severe AH is associated with a high short-term mortality (30% at 90 days, 50% at one-year) and in many cases infections are responsible for deaths. Given the link between alcohol, systemic inflammation and altered bone marrow haematopoesis, we investigated whether circulating red cell parameters may help in diagnoses of AH and provide prognostic information relating to disease severity, infection and survival outcomes. We used a Sysmex XN-1000 haematology instrument to analyse red cells in patients with AH(n=59), abstinent(n=32) and drinking (n=14) ALD compensated cirrhosis, decompensated alcoholic cirrhosis patients(n=39) and healthy controls(n=40). RCDW was compared with liver function tests and demographic features including mortality and infection risk. Our data confirmed that there was a reduction in circulating red cell count in AH but RCDW was elevated in AH and cirrhotic patients who were still actively drinking compared to the other groups. Longitudinal measurements suggested that values normalized over time in drinkers who were abstinent whilst under clinical investigation. 28 day and 1 year mortality was significantly reduced in AH patients with the highest RCDW and there was a significant correlation between GAHS and RCDW. We also noted a trend for increased risk of infection in patients with the highest RCDW but overall reported infectious complications in our unit were low as a result of prophylactic antibiotic prescribing. These findings are suggestive that the presence of acute inflammatory liver disease is associated with alterations in RCDW, and this should be investigated as a potential prognostic marker or indicator of infection risk in AH.
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0017-5749
    EISSN: 1468-3288
    DOI: 10.1136/gutjnl-2023-BASL.33
  • Source: ProQuest Central
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