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Value of Red Cell Distribution Width in Assessing the Severity of Hepatitis B Virus-Related Decompensated Cirrhosis by Meiyu Zhang, Siyuan Chen, Xuan Zhu, Aidan Huang, Fang Lan, Huaping Chen, Shan Li, Xue Qin

Background: Hepatitis B virus infection is the main reason for liver cirrhosis in China. Thus, evaluating the disease severity of hepatitis B-related decompensated cirrhosis (HBV-DeCi) is very important. The red cell distribution width (RDW) is thought to be correlated with the severity of various diseases. The purpose of this investigation is to verify whether RDW can estimate the disease severity of HBV-DeCi.
Methods: This retrospective study included 172 subjects who had been diagnosed with HBV-DeCi. They were categorized into three groups on the basis of their RDW values. Receiver operating curve (ROC) was used to estimate the severity predictive performances and binary logistic regression was used to assess the independent variable predicting the severity of liver disease.
Results: The RDW values were evidently increased in the HBV-DeCi patients in comparison with the healthy controls (18.00% ± 0.04 vs. 13.19% ± 0.74, p < 0.001). There was also a significant difference in the model for endstage liver disease score of the three different RDW groups of A, B and C (13.2 ± 4.6, 16.0 ± 9.0, and 18.8 ± 6.5, p = 0.002). The RDW was an independent risk factor of the severity of HBV-DeCi. The cutoff level for RDW was > 14.0%, where the sensitivity and specificity were 90.7%, 100.0%, respectively, and the area under the curve (AUC) of ROC was 0.969. For a combination of RDW and MELD score, the AUC was 0.997, and the sensitivity and specificity were 98.3% and 99.1%, respectively.
Conclusions: The RDW is a simple biomarker that may play an important role in predicting the severity of HBVDeCi.

DOI: 10.7754/Clin.Lab.2017.170331