Utility of Neutrophil to Lymphocyte Ratio as a Predictor of Complications in Patients with Liver Cirrhosis.

ABSTRACT

Neutrophil to Lymphocyte Ratio (NLR) has been considered an inexpensive biomarker to reflect inflammation in patients with cirrhosis. Raised NLR has been associated with poor clinical outcome and mortality in these patients. We conducted this study to correlate the association of Neutrophil to Lymphocyte Ratio with complications of cirrhosis and assess the short-term outcome during hospital admission. MethodsWe conducted a prospective observational study in 120 patients with cirrhosis from January 2017 to June 2018. All patients were diagnosed based on clinical history, examination and ultrasound. Complications were diagnosed by clinical and laboratory evaluation. Total white blood cell count, lymphocyte count, and neutrophil count were recorded, and neutrophil to lymphocyte ratio was calculated. Statistical analysis by means of test of association and binary logistic regression analysis was carried out. ResultsOut of the 120 patients enrolled in our study, majority were male (90%), and in the age group 51 - 60 years (38.3%). Majority (39.2%) of the patients had portal hypertension with oesophageal variceal bleeding as complication. Mean NLR for the patients was 5.824. A total of 91% patients with NLR>12 were admitted with decompensated liver disease and 66.7% of those patients presented with more than 2 complications that is hepatic encephalopathy and spontaneous bacterial peritonitis. 41.7% patients with NLR >12 had mortality as the outcome. Chi square test of association of NLR with complications (p=0.003) and mortality (p=0.03) were significant. However, NLR could not predict complications in our study population. ConclusionsRaised Neutrophil to Lymphocyte Ratio is associated with complication and mortality in patients with cirrhosis. However, it could not effectively predict the complications in patients with cirrhosis.