Pediatr Gastroenterol Hepatol Nutr.  2024 Sep;27(5):286-297. 10.5223/pghn.2024.27.5.286.

Evaluating the Association between Anemia and the Severity of Liver Disease in Children with Cirrhosis: A Cross-Sectional Study from 2015 to 2020

Affiliations
  • 1Shiraz Transplant Research Center, Shiraz University of Medical Science, Shiraz, Iran
  • 2Department of Pediatrics, School of Medicine, Namazi Teaching Hospital, Abu Ali Sina for Medicine & Organ Transplant, Shiraz University of Medical Sciences, Shiraz, Iran
  • 3Blood Transfusion Research Centre, Higher Institute for Research and Education in Transfusion Medicine, Shiraz, Iran
  • 4Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran

Abstract

Purpose
Liver cirrhosis is a major cause of hospital admission and mortality among children. Understanding the factors that influence disease severity is essential for preventing and reducing mortality. This study explored the association between hemoglobin levels and liver disease severity in children with cirrhosis.
Methods
This cross-sectional study included 326 children with cirrhosis admitted to Namazi Teaching Hospital between 2015 and 2020. Clinical data, Child–Turcotte–Pugh (CTP) scores, and pediatric end-stage liver disease/model for end-stage liver disease (PELD/MELD) scores were collected to assess disease severity. Anemia was defined based on age, sex, and hemoglobin levels.
Results
Among the children with cirrhosis, 275 (84.4%) were anemic, with a mean age of 5.4±4.8 years. The overall mean hemoglobin level was 9.2±2.1 g/dL. A significant inverse correlation was observed between hemoglobin levels and CTP and PELD/MELD scores in children with anemia (p<0.001). Moreover, lower hemoglobin levels were associated with more higher CTP classes (p<0.001).
Conclusion
According to the data analysis, a significant correlation was observed between hemoglobin level and the severity of liver disease, and hemoglobin level decreased with increasing severity of liver disease. According to CTP class, the mean hemoglobin level decreased progressively as the disease progressed. A comparison of the mean CTP scores between children with and those without anemia revealed that those with anemia had more severe disease than those without anemia.

Keyword

Anemia; Liver cirrhosis; Child; Hemoglobins; Liver diseases
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