Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
LIPPINCOTT WILLIAMS & WILKINS
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objectives 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 long-term mortality in patients with stable liver cirrhosis. Materials and methods This is a retrospective observational cohort study in which 145 stable cirrhotic patients without infection, hepatocellular carcinoma, and ongoing steroid therapy were enrolled between January 2009 and December 2011. The primary end point was survival during follow-up. NLR along with Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD) scores, and Charlson comorbidity index were assessed for the prediction of mortality. Results There were 86 men and 59 women, mean age 58.9 +/- 13.4 years. The etiologies of liver cirrhosis included viral hepatitis (n = 73), cryptogenic (50), alcoholic (12), and other (10). The mean follow-up duration was 27.8 +/- 6.8 months, during which 40 patients died. The mean NLRs were 2.08 +/- 0.99 and 4.39 +/- 3.0 in surviving and nonsurviving patients, respectively (P < 0.001). Kaplan-Meier survival analysis was carried out according to the median NLR above and below 2.72. Patients with NLR of at least 2.72 had a significantly lower survival (log rank, P < 0.001). NLR was found to be an independent predictor of mortality in all Cox Regression models (odds ratio 1.2; 95% confidence interval 1.2-1.3; P < 0.001). Receiver operating characteristic analysis showed that cut-off values of 4.22, 3.07, and 2.96 for NLR predicted 12, 24, and 36-month mortality, respectively (AUC: 0.806, P = 0.0029; 0.841, P < 0.0001 and 0.783, P < 0.0001, respectively). Conclusion NLR is a predictor of mortality independent of CTP and MELD scores in patients with liver cirrhosis. NLR could predict mortality in the subgroup of patients with low MELD scores as well. Eur J Gastroenterol Hepatol 25:435-441 (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2013, 25:435-441
Açıklama
Anahtar Kelimeler
CTP score, liver cirrhosis, MELD score, mortality, neutrophil-to-lymphocyte ratio
Kaynak
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
WoS Q Değeri
Q3
Scopus Q Değeri
Q2
Cilt
25
Sayı
4
