scholarly journals Neutrophil-to-Lymphocyte Ratio and Albumin: New Serum Biomarkers to Predict the Prognosis of Male Alcoholic Cirrhosis Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mingyuan Zhang ◽  
Yu Zhang ◽  
Lili Liu ◽  
Mozumder Prithweeraj ◽  
Hongqin Xu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Roc Curve ◽  
Alcoholic Cirrhosis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Prognostic Scores ◽  
Patient Death ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Short Term Mortality

Background and Aims. Alcohol-associated liver disease is exhibiting an increasing disease burden. In terms of pathogenesis, inflammation is closely related to alcohol-induced liver injury. The neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory biomarker. Here, we aim to evaluate the role of the NLR and other biomarkers in predicting short-term mortality in alcoholic cirrhotic patients. Methods. This was a retrospective study that included 459 male alcoholic cirrhosis patients. Among them, 345 patients completed follow-up. Based on their 30-day mortality information, patients were separated into surviving and nonsurviving groups. Demographic, clinical, and biochemical features were collected for further analysis. Logistic regression was used to identify factors associated with short-term mortality, and receiver operating characteristic (ROC) curve analysis was used to establish the predictive value of these factors. Results. The prognostic scores were significantly higher in the nonsurviving group than in the surviving group: NLR: 5.5 vs. 3.2 ( P < 0.001 ), model for end-stage liver disease (MELD): 15.4 vs. 7.9 ( P < 0.001 ), Maddrey’s discriminant function (MDF): 39.8 vs. 12.7 ( P < 0.001 ), and the integrated MELD (i-MELD): 37.9 vs. 28.4 ( P < 0.001 ). Logistic regression demonstrated that albumin (ALB), NLR, and i-MELD values were significantly correlated with patient death in 30 days. On ROC analysis, the diagnostic accuracy for 30-day mortality of the NLR (area under the ROC curve (AUROC) of 0.72, P < 0.001 ) was similar to that of the MELD or i-MELD (AUROCs of 0.71 and 0.74, respectively, P < 0.001 ). The new biomarker, NLA, calculated as 100 × NLR / ALB , had the best prognostic value. The cutoff values of the NLR and NLA for predicting 30-day mortality were 4.2 and 19.6, respectively. Conclusions. The NLR and its related biomarker NLA are simple and robust predictors of 30-day mortality in alcoholic cirrhosis patients.

scholarly journals Baseline Neutrophil-to-Lymphocyte Ratio Is Independently Associated With 90-Day Transplant-Free Mortality in Patients With Cirrhosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Liu ◽  
Hai Li ◽  
Jie Xia ◽  
Xianbo Wang ◽  
Yan Huang ◽  
...  
Keyword(s):  
Cubic Splines ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Infection Group ◽  
Lymphocyte Ratio ◽  
Increased Risk ◽  
Unit Increase ◽  
Short Term Mortality ◽  
Cirrhotic Patients ◽  
Restricted Cubic Splines

Background: Patients with cirrhosis have an increased risk of short-term mortality, however, few studies quantify the association between neutrophil-to-lymphocyte ratio (NLR) and 90-day transplant-free mortality in cirrhotic patients.Methods: We prospectively analyzed 3,970 patients with chronic liver diseases from two multicenter cohorts in China (January 2015 to December 2016 and July 2018 to January 2019). Restricted cubic splines (RCS) were used to analyze the relation of NLR and all-causes 90-day transplant-free mortality in cirrhosis.Results: A total of 2,583 cirrhotic patients were enrolled in our study. Restricted cubic splines showed that the odds ratio (OR) of all causes 90-day transplant-free mortality started to increase rapidly until around NLR 6.5, and then was relatively flat (p for non-linearity &lt;0.001). The risk of 90-day transplant-free mortality in cirrhotic patients with NLR &lt; 6.5 increased with an increment of 23% for every unit increase in NLR (p &lt; 0.001). The patients with NLR &lt; 4.5 had the highest risk (OR: 2.34, 95% CI 1.66–3.28). In multivariable-adjusted stratified analyses, the increase in the incidence of 90-day transplant-free mortality with NLR increasing was consistent (OR &gt;1.0) across all major prespecified subgroups, including infection group (OR: 1.04, 95% CI 1.00–1.09) and non-infection (OR: 1.06, 95% CI 1.02–1.11) group. The trends for NLR and numbers of patients with organ failure varied synchronously and were significantly increased with time from day 7 to day 28.Conclusions: We found a non-linear association between baseline NLR and the adjusted probability of 90-day transplant-free mortality. A certain range of NLR is closely associated with poor short-term prognosis in patients with cirrhosis.

scholarly journals Prognostic Value of Neutrophil to Lymphocyte Ratio and Risk Factors for Mortality in Patients with Stanford Type A Aortic Dissection

2017 ◽  
Vol 20 (3) ◽  
pp. 119 ◽  
Author(s):  
Kursad Oz ◽  
Taner Iyigun ◽  
Zeynep Karaman ◽  
Ömer Çelik ◽  
Ertan Akbay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Aortic Dissection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
Operating Characteristics ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Wide Range ◽  
Short Term Mortality

Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to survivors (11.6 ± 2.4 versus 6.6 ± 2.3, P < .001). In multivariate analysis, high NLR (odds ratio [OR] 1.913, 95% CI 1.030-1.081, P = .04) and cross-clamp time (OR 1.265, 95% CI 1.003-1.596, P = .04) were determined as independent predictors of in-hospital mortality. In receiver operating characteristics curve analyses, the NLR > 9.3 predicted the mortality in AD with a specificity of 91% and a sensitivity of 86% (P < .001).Conclusion: This study shows that high NLR can be used as a marker for prognosis in short-term mortality of patient with AD. Additionally, increased lactate level in perioperative period, prolonged cardiopulmonary bypass time, and additional cardiac procedures are strong independent predictors of short-term mortality in patients with acute AD.

scholarly journals Neutrophil to lymphocyte ratio in predicting short-term mortality in hemodialysis patients

2013 ◽  
Vol 30 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Emre Erdem ◽  
Coşkun Kaya ◽  
Ahmet Karataş ◽  
Melda Dilek ◽  
Tekin Akpolat
Keyword(s):  
Hemodialysis Patients ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Short Term Mortality

scholarly journals Role of circulatory leukocyte based indices in short-term mortality of patients with heart failure with reduced ejection fraction

2020 ◽  
Author(s):  
Mohammadreza Taban Sadeghi ◽  
Ilqhar Esgandarian ◽  
Masoud Nouri-Vaskeh ◽  
Ali Golmohammadi ◽  
Negin Rahvar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Short Term ◽  
Reduced Ejection Fraction ◽  
Lymphocyte Ratio ◽  
Patients With Heart Failure ◽  
Short Term Mortality

Background. Pro-inflammatory signaling is mediated by a variety of inflammatory mediators which can cause myocardial apoptosis, hypertrophia, and fibrosis, and also ultimately lead to adverse cardiac remodeling. This study aimed to assess the role of circulating leukocyte-based indices in predicting the short-term mortality in patients with heart failure with reduced ejection fraction (HFrEF). Methods. In a retrospective study, patients with HFrEF admitted to a tertiary referral center between January 2016 and January 2017 were recruited to this study. The association between neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dLNR = neutrophils/(leukocytes-neutrophils)), monocyte/granulocyte to lymphocyte ratio (MGLR = (white cell count-lymphocyte count) to lymphocyte count), platelet to lymphocyte ratio (PLR) and six-months mortality of patients were assessed. Results. A total of 197 patients with HFrEF were enrolled in the study. NLR (P<0.001), dNLR (P<0.001), MGLR (P<0.001), PLR (P=0.006) and LVEF (P=0.042) showed significant difference between survived and died patients. In the Cox multivariate analysis we did not find NLR, dLNR, MGLR or PLR as an independent predictor of short-term mortality in HFrEF patients. Conclusions. Although High NLR, PLR, MGLR and dNLR was associated with short-term mortality, it failed to independently predict the prognosis of HFrEF patients.

scholarly journals Evaluation of treatment outcome in patients with acute-on-chronic liver failure using clinical scores

2020 ◽  
Vol 148 (3-4) ◽  
pp. 153-159
Author(s):  
Tamara Milovanovic ◽  
Milica Stojkovic-Lalosevic ◽  
Sanja Dragasevic ◽  
Nevena Jocic ◽  
Marko Baralic ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Failure ◽  
High Mortality ◽  
Chronic Liver ◽  
Apache Ii ◽  
Prognostic Scores ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality ◽  
Precise Prediction

Introduction/Objective. Due to a very high mortality risk, acute-on-chronic liver failure (ACLF) patients require early identification and intensive treatment. Precise prediction is crucial for determining the urgency degree and therapy appropriateness, considering high mortality and multitude of clinical resources. The aim of our study was to determine the exact cut-off values of various prognostic scores in the prediction of morality of ACLF. Methods. This prospective study includes chronic liver disease (CLD) patients, admitted due to decompensation, that were subsequently diagnosed with ACLF at the Emergency unit. All patients were evaluated based on various prognostic scores, including Child?Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C, which were calculated on admission. Results. Alcoholic liver disease (ALD) was the most common underlying CLD cause (77.9%), followed by viral (8.6%), autoimmune (7.7%), and other causes (5.8%). A total of 37.5% of the patients died at the end of the first month of treatment. Average values of Child?Pugh, MELD Na, MELD, SOFA, APACHE II, and CLIF C scores were significantly higher in patients who died compared to survivors (p < 0.05). CLIF C score showed the best performance with a cut-off value of 50.5, with a sensitivity of 94.9% and specificity of 40%. Conclusion. ACLF remains a condition with a high short-term mortality. Of all of the scores examined in our study, CLIF C proved to be the best scoring system for predicting short term and end of treatment mortality in patients with ACLF.

scholarly journals Acute on chronic liver failure- etiology, clinical profile, prognostic scores: experience from tertiary care centre of eastern India

2021 ◽  
Vol 9 (11) ◽  
pp. 3405
Author(s):  
Sanatan Behera ◽  
Vivek Prakash ◽  
Shivam Bajpai ◽  
Umesh Chandra Patra ◽  
Sushanta Kumar Jena
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Liver Failure ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Prognostic Scores ◽  
Eastern India ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Short Term Mortality

Background: Acute on chronic liver failure (ACLF) is a recently recognised entity in chronic liver disease patients. Data regarding ACLF in terms of clinical presentation, etiology of underlying cirrhosis, precipitating factors, prognostic factors are lacking from eastern India. The present study was undertaken to evaluate the above factors along with the assessment of short-term mortality (4 weeks) in patients of ACLF.Methods: In this prospective observational study, 120 patients diagnosed as ACLF were included. A comparison of complications, biochemical profiles and prognostic scores was made between the survivor and non-survivor groups.Results: Of the 120 ACLF patients included, the mean age was 44.9±8.6 years and the male to female ratio was 2.5:1. Common clinical presentations were jaundice (100%), ascites (88.3%), hepatic encephalopathy (60%). The most common etiology for underlying CLD was alcohol (51.7%) followed by chronic hepatitis B (20%) and chronic hepatitis C (15%) infection. Alcohol hepatitis (40%) followed by hepatotropic viral infections (20%) and drug-induced liver injury (15%) were common identifiable precipitating agents. After a follow-up period of 4 weeks, 56 (46.6%) out of 120 patients died. The presence of sepsis, hyponatremia, renal failure, and coagulopathy was significantly associated with high mortality. Mortality was higher among patients having high Chronic liver failure consortium- acute on chronic liver failure (CLIF-ACLF) grade and closely related to the number of organ failures.Conclusions: ACLF is a rapidly progressive syndrome in chronic liver disease patients, having high short-term mortality.

scholarly journals Short-Term Variations in Neutrophil-to-Lymphocyte and Urea-to-Creatinine Ratios Anticipate Intensive Care Unit Admission of COVID-19 Patients in the Emergency Department

2021 ◽  
Vol 7 ◽  
Author(s):  
Antonio Giovanni Solimando ◽  
Nicola Susca ◽  
Paola Borrelli ◽  
Marcella Prete ◽  
Gianfranco Lauletta ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Logistic Regression ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Medical Ward ◽  
Neutrophil To Lymphocyte Ratio ◽  
Creatinine Ratio ◽  
Short Term ◽  
Lymphocyte Ratio

Background: Timely assessment of COVID-19 severity is crucial for the rapid provision of appropriate treatments. Definitive criteria for the early identification of severe COVID-19 cases that require intensive care unit admission are lacking.Methods: This was a single-center, retrospective case-control study of 95 consecutive adults admitted to the intensive care unit (cases) or a medical ward (controls) for laboratory-confirmed COVID-19. Clinical data were collected and changes in laboratory test results were calculated between presentation at the emergency department and admission. Univariate and multivariable logistic regression was performed to calculate odds ratios for intensive care unit admission according to changes in laboratory variables.Results: Of the 95 adults with COVID-19, 25 were admitted to intensive care and 70 to a medical ward after a median 6 h stay in the emergency department. During this interval, neutrophil counts increased in cases and decreased in controls (median, 934 vs. −295 × 106/L; P = 0.006), while lymphocyte counts decreased in cases and increased in controls (median, −184 vs. 109 × 106/L; P &lt; 0.001). In cases, the neutrophil-to-lymphocyte ratio increased 6-fold and the urea-to-creatinine ratio increased 20-fold during the emergency department stay, but these ratios did not change in controls (P &lt; 0.001 for both comparisons). By multivariable logistic regression, short-term increases in the neutrophil-to-lymphocyte ratio (OR = 1.43; 95% CI, 1.16–1.76) and urea-to-creatinine ratio (OR = 1.72; 95% CI, 1.20–2.66) were independent predictors of intensive care unit admission.Conclusion: Short-time changes in neutrophil-to-lymphocyte ratio and urea-to-creatinine ratio emerged as stand-alone parameters able to identify patients with aggressive disease at an early stage.

scholarly journals An increased pretreatment neutrophil-to-lymphocyte ratio predicts severe novel coronavirus-infected pneumonia

2020 ◽  
Author(s):  
Xiaoyue Wang ◽  
Desheng Jiang ◽  
Huang Huang ◽  
Xiaofeng Chen ◽  
Chunlei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Early Warning ◽  
Roc Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Independent Risk Factors ◽  
Novel Coronavirus

Abstract Objective The aim of this study was to identify early warning signs for severe novel coronavirus-infected pneumonia (COVID-19).Methods We retrospectively analyzed the clinical data of 90 patients with COVID-19 at the Guanggu District of Hubei Women and Children Medical and Healthcare Center comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. Logistic regression analysis was performed to identify the independent risk factors that predicted severe COVID-19. The receiver-operating characteristic (ROC) curve of independent risk factors was calculated, and the area under the curve (AUC) was used to evaluate the efficiency of the prediction of severe COVID-19.Results The patients with mild and severe COVID-19 showed significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and the serum albumin (ALB) level (P<0.05). The severity of COVID-19 was correlated positively with the comorbidity of cancer, age, NLR, and CRP but was negatively correlated with the ALB level (P<0.05). Multivariate logistic regression analysis showed that the NLR and ALB level were independent risk factors for severe COVID-19 (OR=1.319, 95% CI: 1.043-1.669, P=0.021; OR=0.739, 95% CI: 0.616-0.886, P=0.001), with AUCs of 0.851 and 0.128, respectively. An NLR of 4.939 corresponded to the maximum joint sensitivity and specificity according to the ROC curve (0.700 and 0.917, respectively).Conclusion An increased NLR can serve as an early warning sign of severe COVID-19.

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