Neutrophil-to-lymphocyte ratio may be a useful marker of mortality in septic patients with liver cirrhosis

1. In septic patients with liver cirrhosis, the neutrophil-to-lymphocyte (NLR) ratio was positively correlated with all-cause mortality.

Evidence Rating Level: 1 (Good)

Sepsis-related mortality among patients with liver cirrhosis is much greater than in patients without liver cirrhosis. NLR has been previously shown to be a reliable predictor of mortality in other inflammation-related diseases such as malignant tumours, yet investigations into the role of NLR as a prognostic marker in septic patients with liver cirrhosis remain limited. This retrospective cohort study therefore sought to investigate the association of NLR with mortality risk in septic patients with liver cirrhosis. 1372 patients from the Beth Israel Deaconess Medical Center between 2008 and 2019 with sepsis and liver cirrhosis were included in the study. The primary outcome was all-cause mortality during hospitalization. NLR was significantly associated with all-cause mortality in both unadjusted (Odds Ratio (OR): 1.03, 95% CI: 1.02–1.04) and adjusted models (Model I: OR: 1.03, 95% CI: 1.01–1.04; Model II: OR: 1.02, 95% CI: 1.00–1.04). When compared with neutrophils alone or Sequential Organ Failure Assessment (SOFA) scores, NLR demonstrated a superior predictive value (area under the curve (AUC) = 0.752 versus 0.711 and 0.711 for neutrophils and SOFA scores). Overall, this study found that the NLR ratio was significantly correlated with all-cause mortality. 

Click to read the study in BMC Gastroenterology

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