Clinical and Laboratory Indicators Associated with Cirrhosis Severity

This study aimed to evaluate clinical and laboratory indicators associated with varying cirrhosis severity, with the objective of supporting more accurate clinical assessment and stratification.

A retrospective analysis was conducted on 180 patients diagnosed with cirrhosis and treated at the People's Hospital of Zhengzhou between January 1, 2020, and February 1, 2023. Patients were stratified into three groups based on the Child-Pugh classification: grade A (n = 73), grade B (n = 68), and grade C (n = 39). Statistical analyses were performed to identify associations between clinical and laboratory variables and cirrhosis severity.

No statistically significant differences were observed among the three groups with respect to gender, age, diarrhea, abdominal distension, or abdominal pain (p > 0.05). Fever and spontaneous bacterial peritonitis were more frequently observed in patients with advanced disease (p < 0.05). The presence of hepatitis B, hepatitis C, cholestasis, malnutrition, circulatory disorders, and other etiologies showed no significant association with cirrhosis severity (p > 0.05). Similarly, portal vein diameter, upper gastrointestinal hemorrhage, alcohol use history, smoking status, and esophagogastric varices did not differ significantly among groups (p > 0.05). Laboratory parameters significantly associated with cirrhosis severity included serum calcium (Ca²⁺), white blood cell count (WBC), platelet count (PLT), C-reactive protein (CRP), hemoglobin (Hb), fibrinogen (FIB), total bile acids (TBA), apolipoprotein A1 (APOA1), direct bilirubin (DBIL), cholinesterase (CHE), cystatin C (CYSC), and bicarbonate (HCO3-) (p < 0.05). TBA and DBIL levels were positively correlated with disease severity, while FIB, APOA1, CHE, and HCO3- levels were negatively correlated.

Fever, spontaneous bacterial peritonitis, and several laboratory markers, namely CRP, PLT, FIB, TBA, Ca²⁺, APOA1, CHE, CYSC, and HCO3-, may serve as relevant indicators for assessing cirrhosis severity. Recognition of these indicators may support improved clinical stratification and guide management decisions.