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Research Paper | Medicine | India | Volume 12 Issue 7, July 2023
Utility of Neutrophil to Lymphocyte Ratio as a Predictor of Complications in Patients with Liver Cirrhosis
Dr. Suraj Bhola | Dr. Hardip Singh Nirman | Dr. Gurpreet Singh Chhina
Abstract: Background: Cirrhosis is a serious and irreversible disease which is considered as the final stage of chronic liver disease. The major complications of cirrhosis include ascites, hepatic encephalopathy, upper GI bleed, and spontaneous bacterial peritonitis. [4] The neutrophil to lymphocyte ratio (NLR) is a biomarker of immune dysregulation in patients with cirrhosis and is inexpensive to measure. The present study was conducted to examine the association of neutrophil to lymphocyte ratio with complications, and decompensation in patients with cirrhosis of liver. Materials & Methods: This was conducted on 50 patients in the department of Medicine, Government Medical College, Amritsar. The study protocol was approved by the institutional ethics committee. The patients were enrolled in the study after obtaining written informed consent. All the patients were interviewed and clinically examined. Neutrophil to lymphocyte ratio was calculated for every patient. The results were then analyzed. Results: The mean age was 52.50 + 8.31 years with a male preponderance (78% male vs 22% female patients). Neutrophil - lymphocyte ratio (NLR) was normal (<3) in 19 (38%) patients, while it was elevated (>3) in 31 (62%) patients. NLR was in the range of 1.47 - 18.33. Majority of the patients (38 patients; 76%) had various complications. Out of these complications, ascites (76%) was the most common complication followed by Hepatic encephalopathy (52%), upper GI bleed (36%), and Spontaneous bacterial peritonitis (26%). The relation of NLR was significant for alcoholism, hepatic encephalopathy, spontaneous bacterial peritonitis, upper GI bleed and ascites; and highly significant for Child - Turcotte - Pugh (CTP) scoring. Conclusion: The present study found that NLR, which is widely available and inexpensive biomarker of systemic inflammation, can be used as a screening tool in predicting occurrence of complications (e. g., hepatic encephalopathy, spontaneous bacterial peritonitis, ascites, and upper GI bleed) and indirectly predicting the short - term mortality in patients with liver cirrhosis. It can also be used as prognostic marker to detect decompensation in these patients.
Keywords: Liver cirrhosis, Neutrophil to lymphocyte ratio, Ascites, Child - Turcotte - Pugh (CTP) scoring, Spontaneous bacterial peritonitis
Edition: Volume 12 Issue 7, July 2023,
Pages: 1367 - 1371