Open AccessPrognostic value of the neutrophil‐to‐lymphocyte ratio in patients with acute‐on‐chronic liver failure
Author(s) -
Chen L.,
Lou Y.,
Chen Y.,
Yang J.
Publication year - 2014
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12408
Subject(s) - medicine , neutrophil to lymphocyte ratio , gastroenterology , lymphocyte , proportional hazards model , multivariate analysis , liver disease , chronic liver disease , liver function , cirrhosis
Summary Objectives The neutrophil‐to‐lymphocyte ratio ( NLR ) is a novel inflammation index that has been shown to independently predict poor clinical outcomes. We aimed to evaluate the role of NLR in the prediction of 3‐month mortality in patients with acute‐on‐chronic liver failure (Ao CLF ). Methods One hundred and twenty‐seven patients, including 46 patients with chronic hepatitis B ( CHB ), 81 with Ao CLF and 58 healthy controls ( HC s), were enrolled in the study. All patients were followed up for 4 months. The primary end‐point was in‐hospital mortality at the end of 90 days. A blood sample was collected for all subjects at admission to examine liver function, renal function, international normalised ratio, C‐reactive protein and neutrophil and lymphocyte counts, and NLR s were calculated. A total of six clinical chemistry and biochemical variables were analysed for potential associations with outcomes using Cox proportional hazards and multiple regression models. Results Acute‐on‐chronic liver failure patients had significantly higher NLR s on admission compared with HC s and CHB patients (all p = 0.001). Patients with elevated NLR s were associated with increased severity of liver disease and 3‐month mortality rates. According to multivariate analysis, only NLR was an independent predictor for mortality (p = 0.025). Conclusions The NLR measured at admission can serve as an independent predictor for 3‐month mortality rate in Ao CLF patients.