Haematological Profile in Patients with Decompensated Liver Disease in a Tertiary Care Centre

Background: Decompensated liver disease (DLD) is characterised by the liver's inability to perform its normal synthetic and detoxifying functions, leading to systemic complications. Haematological abnormalities are commonly observed in DLD patients, influencing disease progression and patient outcomes. Methods: This is a prospective cohort study conducted at ACS Medical College and Hospital, Chennai, from March 2023 to March 2024. A total of 25 patients aged over 18 years with clinical evidence of decompensated chronic liver disease were included. Patients without signs of decompensation were excluded. Results: Anemia was observed in 100% of patients. Three patients had severe anemia (Hb <6 g/dL), while the rest had mild to moderate anemia (Hb 6-12.9 g/dL). Normocytic morphology was the most common RBC pattern. Thrombocytopenia was seen in 75% of patients. Four patients had severe thrombocytopenia (<50,000/mm?), all associated with splenomegaly. Fourteen had platelet counts between 50,000?150,000/mm?. Hepatic coagulopathy (INR >1.1 and prolonged PT) was found in 80% (18 males and 2 females), though bleeding manifestations were seen in only 10 patients, with in-hospital bleeding in 2 cases. Leukocytosis was more prevalent than leukopenia and was particularly noted in cases with spontaneous or secondary bacterial peritonitis. Conclusion: Anaemia is the most common haematological abnormality in decompensated liver disease, followed by thrombocytopenia and coagulopathy. While abnormal coagulation profiles were frequent, clinical bleeding was not universal. Haematological monitoring and early intervention are vital in reducing morbidity and mortality in cirrhotic patients.