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Prognostic impact of neutrophil‐to‐lymphocyte ratio in cirrhosis: A propensity score matching analysis with a prespecified cut‐point
Author(s) -
Deng You,
Fan Xiaofei,
Ran Ying,
Xu Xin,
Lin Lin,
Cui Binxin,
Hou Lijun,
Zhao Tianming,
Wang Ya,
Su Zhengyan,
Jiang Xihui,
Zhao Wei,
Wang Bangmao,
Sun Chao
Publication year - 2019
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14211
Subject(s) - propensity score matching , neutrophil to lymphocyte ratio , medicine , cirrhosis , lymphocyte , matching (statistics) , immunology , gastroenterology , pathology
Background & Aims An elevated neutrophil‐to‐lymphocyte ratio (NLR) has received attention as a prognostic surrogate across chronic liver diseases. However, an exact threshold has not been fully elucidated. Methods A total number of 589 patients with cirrhosis (LC) were included. The value of NLR was calculated and its optimal cut‐off was initially determined by X‐tile program. Independent predictors of 90‐day mortality were identified with Cox regression model. The Kaplan‐Meier method was used to generate survival curves. To reduce influences of selection bias and possible confounders, a 1:2 propensity score matching (PSM) was performed. Results The X‐tile indicated that the difference in survival was most significant for NLR more than 8.9. Serum NLR > 8.9 was an independent indicator in the entire cohort and PSM subset (HR 4.268, 95% CI 2.211‐8.238, P < .001; HR 4.209, 95% CI 1.448‐12.238, P = .008 respectively). Subgroup analysis showed that NLR > 8.9 was an independent risk factor of 90‐day mortality regardless of age, gender, CTP or MELD score. Conclusions The value of NLR more than 8.9 is a feasible cut‐off across clinical settings among applicable population. The adding of NLR to other conventional predictive systems has the potential to provide incremental value without extra economic cost.