The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis
Liver cirrhosis patients are highly susceptible to infections, affecting survival, but current parameters for detecting infection are not reliable enough in this population. We investigated the ability of white blood cell (WBC), ∆WBC, neutrophil and ∆neutrophil counts, neutrophil-to-lymphocyte (NLR)...
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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/18/2954 |
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| author | Tamás Janka Dávid Tornai Mária Papp Zsuzsanna Vitális |
| author_facet | Tamás Janka Dávid Tornai Mária Papp Zsuzsanna Vitális |
| author_sort | Tamás Janka |
| collection | DOAJ |
| description | Liver cirrhosis patients are highly susceptible to infections, affecting survival, but current parameters for detecting infection are not reliable enough in this population. We investigated the ability of white blood cell (WBC), ∆WBC, neutrophil and ∆neutrophil counts, neutrophil-to-lymphocyte (NLR) and ∆NLR ratios and C-reactive protein (CRP) and procalcitonin (PCT) levels to identify infection and predict short-term mortality in liver cirrhosis patients. We recruited 233 patients with liver cirrhosis hospitalized with acute decompensation (AD) who had an outpatient visit within 1 month (baseline laboratory data) and followed them for 90 days. Difference between laboratory values at baseline and the AD episode was defined as delta (∆) values of the parameters. Delta values did not increase the diagnostic and predictive ability of investigated parameters. The CRP level was found to be the best diagnostic marker for infection in patients with cirrhosis. However, NLR seems to be superior for short-term mortality prediction, better than the WBC count. Distinguishing inflammations of different origin is a remaining clinical challenge in acutely decompensated cirrhosis. Based on our results, NLR might be more suitable for predicting short-term mortality in patients with AD than the WBC count currently included in the CLIF-C AD score. |
| first_indexed | 2024-03-10T22:52:32Z |
| format | Article |
| id | doaj.art-cc9974530dfd450c842b7362e9ef18d1 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T22:52:32Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-cc9974530dfd450c842b7362e9ef18d12023-11-19T10:13:53ZengMDPI AGDiagnostics2075-44182023-09-011318295410.3390/diagnostics13182954The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated CirrhosisTamás Janka0Dávid Tornai1Mária Papp2Zsuzsanna Vitális3Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, HungaryDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, HungaryDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, HungaryDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, HungaryLiver cirrhosis patients are highly susceptible to infections, affecting survival, but current parameters for detecting infection are not reliable enough in this population. We investigated the ability of white blood cell (WBC), ∆WBC, neutrophil and ∆neutrophil counts, neutrophil-to-lymphocyte (NLR) and ∆NLR ratios and C-reactive protein (CRP) and procalcitonin (PCT) levels to identify infection and predict short-term mortality in liver cirrhosis patients. We recruited 233 patients with liver cirrhosis hospitalized with acute decompensation (AD) who had an outpatient visit within 1 month (baseline laboratory data) and followed them for 90 days. Difference between laboratory values at baseline and the AD episode was defined as delta (∆) values of the parameters. Delta values did not increase the diagnostic and predictive ability of investigated parameters. The CRP level was found to be the best diagnostic marker for infection in patients with cirrhosis. However, NLR seems to be superior for short-term mortality prediction, better than the WBC count. Distinguishing inflammations of different origin is a remaining clinical challenge in acutely decompensated cirrhosis. Based on our results, NLR might be more suitable for predicting short-term mortality in patients with AD than the WBC count currently included in the CLIF-C AD score.https://www.mdpi.com/2075-4418/13/18/2954liver cirrhosismortalityacute decompensationneutrophil-to-lymphocyte ratioC-reactive proteinprocalcitonin |
| spellingShingle | Tamás Janka Dávid Tornai Mária Papp Zsuzsanna Vitális The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis Diagnostics liver cirrhosis mortality acute decompensation neutrophil-to-lymphocyte ratio C-reactive protein procalcitonin |
| title | The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis |
| title_full | The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis |
| title_fullStr | The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis |
| title_full_unstemmed | The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis |
| title_short | The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis |
| title_sort | value of neutrophil to lymphocyte ratio to identify bacterial infection and predict short term mortality in patients with acutely decompensated cirrhosis |
| topic | liver cirrhosis mortality acute decompensation neutrophil-to-lymphocyte ratio C-reactive protein procalcitonin |
| url | https://www.mdpi.com/2075-4418/13/18/2954 |
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