Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration
Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-04-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/9/2463 |
| _version_ | 1797504234370891776 |
|---|---|
| author | Jung Hee Kim Sung-Eun Kim Do-Seon Song Hee-Yeon Kim Eileen L. Yoon Tae-Hyung Kim Young-Kul Jung Ki Tae Suk Baek-Gyu Jun Hyung-Joon Yim Jung-Hyun Kwon Sung-Won Lee Seong-Hee Kang Moon-Young Kim Soung-Won Jeong Jae-Young Jang Jeong-Ju Yoo Sang-Gyune Kim Young-Joo Jin Gab-Jin Cheon Byung-Seok Kim Yeon Seok Seo Hyung-Su Kim Dong-Hyun Sinn Woo-Jin Chung Hwi Young Kim Han Ah Lee Seung-Woo Nam In-Hee Kim Jung-Il Suh Ji-Hoon Kim Hee-Bok Chae Joo-Hyun Sohn Ju-Yeon Cho Yoon-Jun Kim Jin-Mo Yang Jung-Gil Park Won Kim Hyun-Chin Cho Dong Joon Kim |
| author_facet | Jung Hee Kim Sung-Eun Kim Do-Seon Song Hee-Yeon Kim Eileen L. Yoon Tae-Hyung Kim Young-Kul Jung Ki Tae Suk Baek-Gyu Jun Hyung-Joon Yim Jung-Hyun Kwon Sung-Won Lee Seong-Hee Kang Moon-Young Kim Soung-Won Jeong Jae-Young Jang Jeong-Ju Yoo Sang-Gyune Kim Young-Joo Jin Gab-Jin Cheon Byung-Seok Kim Yeon Seok Seo Hyung-Su Kim Dong-Hyun Sinn Woo-Jin Chung Hwi Young Kim Han Ah Lee Seung-Woo Nam In-Hee Kim Jung-Il Suh Ji-Hoon Kim Hee-Bok Chae Joo-Hyun Sohn Ju-Yeon Cho Yoon-Jun Kim Jin-Mo Yang Jung-Gil Park Won Kim Hyun-Chin Cho Dong Joon Kim |
| author_sort | Jung Hee Kim |
| collection | DOAJ |
| description | Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, <i>p</i> = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD. |
| first_indexed | 2024-03-10T04:01:45Z |
| format | Article |
| id | doaj.art-c57e4731dd4e415d86f1be681df47eed |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T04:01:45Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c57e4731dd4e415d86f1be681df47eed2023-11-23T08:32:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01119246310.3390/jcm11092463Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute DeteriorationJung Hee Kim0Sung-Eun Kim1Do-Seon Song2Hee-Yeon Kim3Eileen L. Yoon4Tae-Hyung Kim5Young-Kul Jung6Ki Tae Suk7Baek-Gyu Jun8Hyung-Joon Yim9Jung-Hyun Kwon10Sung-Won Lee11Seong-Hee Kang12Moon-Young Kim13Soung-Won Jeong14Jae-Young Jang15Jeong-Ju Yoo16Sang-Gyune Kim17Young-Joo Jin18Gab-Jin Cheon19Byung-Seok Kim20Yeon Seok Seo21Hyung-Su Kim22Dong-Hyun Sinn23Woo-Jin Chung24Hwi Young Kim25Han Ah Lee26Seung-Woo Nam27In-Hee Kim28Jung-Il Suh29Ji-Hoon Kim30Hee-Bok Chae31Joo-Hyun Sohn32Ju-Yeon Cho33Yoon-Jun Kim34Jin-Mo Yang35Jung-Gil Park36Won Kim37Hyun-Chin Cho38Dong Joon Kim39Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, KoreaDepartment of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, KoreaDepartment of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, KoreaDepartment of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, KoreaDepartment of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, KoreaDepartment of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, KoreaDepartment of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, KoreaDepartment of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, KoreaDepartment of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, KoreaDepartment of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, KoreaDepartment of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22212, KoreaDepartment of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, KoreaDepartment of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, KoreaDepartment of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, KoreaDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, KoreaDepartment of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, KoreaDepartment of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, KoreaDepartment of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, KoreaDepartment of Internal Medicine, National Medical Center, Seoul 04564, KoreaDepartment of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju 54896, KoreaDepartment of Gastroenterology, Dongguk University College of Medicine, Kyongju 38067, KoreaDepartment of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, KoreaDepartment of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju 28644, KoreaDepartment of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, KoreaDepartment of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, KoreaDepartment of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, KoreaDepartment of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, KoreaDepartment of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, KoreaDepartment of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, KoreaDepartment of Internal Medicine, Gyeongsang National University Hospital, Jinju 52727, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, KoreaBackground: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, <i>p</i> = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.https://www.mdpi.com/2077-0383/11/9/2463platelet-to-white blood cell ratioacute-on-chronic liver failureliver cirrhosisacute decompensationadverse outcomes |
| spellingShingle | Jung Hee Kim Sung-Eun Kim Do-Seon Song Hee-Yeon Kim Eileen L. Yoon Tae-Hyung Kim Young-Kul Jung Ki Tae Suk Baek-Gyu Jun Hyung-Joon Yim Jung-Hyun Kwon Sung-Won Lee Seong-Hee Kang Moon-Young Kim Soung-Won Jeong Jae-Young Jang Jeong-Ju Yoo Sang-Gyune Kim Young-Joo Jin Gab-Jin Cheon Byung-Seok Kim Yeon Seok Seo Hyung-Su Kim Dong-Hyun Sinn Woo-Jin Chung Hwi Young Kim Han Ah Lee Seung-Woo Nam In-Hee Kim Jung-Il Suh Ji-Hoon Kim Hee-Bok Chae Joo-Hyun Sohn Ju-Yeon Cho Yoon-Jun Kim Jin-Mo Yang Jung-Gil Park Won Kim Hyun-Chin Cho Dong Joon Kim Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration Journal of Clinical Medicine platelet-to-white blood cell ratio acute-on-chronic liver failure liver cirrhosis acute decompensation adverse outcomes |
| title | Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration |
| title_full | Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration |
| title_fullStr | Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration |
| title_full_unstemmed | Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration |
| title_short | Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration |
| title_sort | platelet to white blood cell ratio is associated with adverse outcomes in cirrhotic patients with acute deterioration |
| topic | platelet-to-white blood cell ratio acute-on-chronic liver failure liver cirrhosis acute decompensation adverse outcomes |
| url | https://www.mdpi.com/2077-0383/11/9/2463 |
| work_keys_str_mv | AT jungheekim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT sungeunkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT doseonsong platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT heeyeonkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT eileenlyoon platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT taehyungkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT youngkuljung platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT kitaesuk platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT baekgyujun platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT hyungjoonyim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT junghyunkwon platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT sungwonlee platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT seongheekang platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT moonyoungkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT soungwonjeong platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT jaeyoungjang platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT jeongjuyoo platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT sanggyunekim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT youngjoojin platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT gabjincheon platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT byungseokkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT yeonseokseo platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT hyungsukim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT donghyunsinn platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT woojinchung platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT hwiyoungkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT hanahlee platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT seungwoonam platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT inheekim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT jungilsuh platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT jihoonkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT heebokchae platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT joohyunsohn platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT juyeoncho platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT yoonjunkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT jinmoyang platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT junggilpark platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT wonkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT hyunchincho platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration AT dongjoonkim platelettowhitebloodcellratioisassociatedwithadverseoutcomesincirrhoticpatientswithacutedeterioration |