Value of neutrophil-lymphocyte ratio in evaluating the short-time prognosis of patients with acute-on-chronic liver failure

Objective To investigate the effect of neutrophil-lymphocyte ratio (NLR) on the 28-day prognosis of patients with HBV-associated acute-on-chronic liver failure (HBV-ACLF) . Methods A total of 100 patients with HBV-ACLF who were admitted to The Second Affiliated Hospital of Anhui Medical University from January 2015 to December 2016 were enrolled, and according to their prognosis on day 28, they were divided into death group and survival group. The data on sex, age, laboratory markers, Model for End-Stage Liver Disease (MELD) score, and clinical complications were collected for univariate analysis. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups. The Chi-square test was used for comparison of categorical data between two groups. Binary logistic regression was used for multivariate analysis. Pearson correlation analysis was used to investigate the correlation between MELD score and NLR. The receiver operating characteristic (ROC) curve was used to analyze the value of indices in predicting the prognosis of HBV-ACLF. Results The analysis of 100 patients with HBV-ACLF showed that there were significant differences between the survival group and the death group in age, albumin, alanine transaminase, serum creatinine, white blood cell count, neutrophil count, lymphocyte count, monocyte count, international normalized ratio, total bilirubin, NLR, and MELD score (all P < 0. 05) . The survival group had lower incidence rates of hepatic encephalopathy, hemorrhage, ascites, and infection than the death group, but there were no significant differences between the two groups (all P > 0. 05) . The binary logistic regression analysis showed that NLR and MELD score were independent predictive factors for 28-day mortality in HBV-ACLF patients (P < 0. 001 and P = 0. 022) , and NLR was positively correlated with MELD score (r = 0. 264, P = 0. 008) . The ROC curve analysis showed that NLR had a significantly larger area under the ROC curve than MELD score (0. 889 vs 0.728, P =0.026 7) . Conclusion NLR is an independent predictive factor for the short-term prognosis of HBV-ACLF patients.