Prognostic value of the neutrophil to lymphocyte ratio in the clinical course of liver cirrhosis

Abstract

Introduction. The search for simple and informative markers for predicting positive outcomes in patients with liver cirrhosis (LC) does not affect its relevance.Aim. To study the possibility of using the “neutrophil to lymphocyte ratio” indicator as a predictor of development of LC complications and death.Materials and methods. For a retrospective clinical study, 225 case histories of patients with LC were selected from 2008 to 2018. Three groups were formed from them: group 1: patients with LC class A according to Child- Pugh (24n); Group 2: patients with LC class B and C according to Child- Pugh (201n); and group 3: healthy individuals (50n). A correlation analysis of the NLR indicator with the Child- Pugh and MELD scales was carried out. The prognostic value of NLR in the development of complications and death was analyzed.Results. Patients with LC had statistically significantly higher values of NLR compared to healthy individuals (p < 0.001). NLR had a statistically significant positive correlation with the Child- Pugh (p < 0.001) and MELD (p < 0.001) scales. NLR is a statistically significant predictor of the development of complications in patients with LC (p = 0.003). A NLR value > 2.3 had a sensitivity of 0.97 [95% CI: 0.92; 0.99] and specificity 0.19 [95% CI: 0.11; 0.29]. NLR statistically significantly correlated with the number of complications of LC (p<0.001) and served as a statistically significant predictor of death (p<0.001). A NLR value > 4.5 had a sensitivity of 0.24 [95% CI: 0.15; 0.36] and specificity 0.97 [95% CI: 0.92; 0.99].Conclusion. An NLR value of more than 2.3 increases the risk of complications in patients with LC, and an NLR value of more than 4.5 increases the risk of death.