Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis

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dc.contributor.authorBiyik, Murat
dc.contributor.authorUcar, Ramazan
dc.contributor.authorSolak, Yalcin
dc.contributor.authorGungor, Gokhan
dc.contributor.authorPolat, Ilker
dc.contributor.authorGaipov, Abduzhappar
dc.contributor.authorCakir, Ozlem O.
dc.date.accessioned2020-03-26T18:41:13Z
dc.date.available2020-03-26T18:41:13Z
dc.date.issued2013
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractObjectives 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, 25:435-441en_US
dc.description.sponsorshipERA-EDTA fellowship programen_US
dc.description.sponsorshipA.G. received grant support from the ERA-EDTA fellowship program.en_US
dc.identifier.doi10.1097/MEG.0b013e32835c2af3en_US
dc.identifier.endpage441en_US
dc.identifier.issn0954-691Xen_US
dc.identifier.issn1473-5687en_US
dc.identifier.issue4en_US
dc.identifier.pmid23249602en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage435en_US
dc.identifier.urihttps://dx.doi.org/10.1097/MEG.0b013e32835c2af3
dc.identifier.urihttps://hdl.handle.net/20.500.12395/29271
dc.identifier.volume25en_US
dc.identifier.wosWOS:000315951200008en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen_US
dc.relation.ispartofEUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectCTP scoreen_US
dc.subjectliver cirrhosisen_US
dc.subjectMELD scoreen_US
dc.subjectmortalityen_US
dc.subjectneutrophil-to-lymphocyte ratioen_US
dc.titleBlood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosisen_US
dc.typeArticleen_US

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