Hematological and Biochemical Alterations in Chronic Liver Disease and Their Correlation with MELD-Na Score and Short-Term Mortality - A Longitudinal Prospective Study

Background: Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months. India contributed to 18.3% of the two million global liver disease–related deaths in 2015. The aim of this study is to assess the changes in hematological and biochemical parameters among CLD patients, their correlation with Model for End- stage Liver Disease – Sodium (MELD Na) Score and predict 28day mortality. This longitudinal prospective study included 205 CLD patients (>14 years age, disease >6 months) at a tertiary center in central India. Patients with Hepatitis A/E, anemia treatment, or bone marrow-suppressing drugs were excluded. Material and Methods: Hematological (TLC, platelet count, hemoglobin, PWR, NLR) and biochemical (bilirubin, AST, ALT) parameters were analyzed across MELD-Na groups and survival status. Statistical analysis of data was presented as median/IQR and analyzed using Kruskal-Wallis, Mann-Whitney, multivariate analysis, and ROC curves. Results: Mortality increased with rising MELD Na scores. Higher MELD Na groups showed increased TLC, NLR , serum bilirubin, ALT, and AST, with decreased platelet count and PWR. Non-survivors had significantly higher TLC, bilirubin, AST, ALT, and lower PWR. Serum bilirubin was the only independent predictor of mortality. ROC analysis showed good predictive accuracy for bilirubin (AUC 0.756; cut-off 3.2 mg/dL, sensitivity 77.3%, specificity 67.6%) and AST (AUC 0.701; cut-off 59.65 U/L, sensitivity 71.2%, specificity 52.5%). Conclusion: Alterations in hematological and biochemical parameters can serve as early indicators of high-risk patients, enabling timely interventions to minimize morbidity and mortality.

Keywords: CLD, Hematological Changes, Biochemical Changes.