Abstract: Objective  To investigate the clinical value of red blood cell distribution width (RDW) in the prognosis of acuteonchronic liver failure. Methods  Totally 78 patients with hepatitis Brelated acuteonchronic liver failure (ACLF) were enrolled and divided into survival and death groups according to their prognosis to detect RDW level and other related clinical indicators in this study. Results  The RDW level in ACLF was significantly increased in nonsurvivors than in survivors (t=-3.568, P=0.004). The level of RDW was correlated with WBC, NLR, TBIL, MELD scores (P<0.05). The area under the ROC curve (AUC) of RDW predicted mortality in ACLF was 0.64(0.520.77) at a cutoff value of  17.15%, and the sensitivity and specificity were 54.2% and 67.9%, respectively. Multivariate regression analysis showed that RDW, NLR and INR were independent risk factors for shortterm mortality of patients with ACLF.  High RDW level showed a significantly lower survival rate (P<0.05).Conclusion  RDW is a simple and effective indicator that can predict the shortterm prognosis of ACLF.

Key words: liver failure, red blood cell distribution width, prognosis