Frontiers in Medicine (Aug 2021)
Baseline Neutrophil-to-Lymphocyte Ratio Is Independently Associated With 90-Day Transplant-Free Mortality in Patients With Cirrhosis
- Jing Liu,
- Jing Liu,
- Hai Li,
- Hai Li,
- Jie Xia,
- Jie Xia,
- Xianbo Wang,
- Xianbo Wang,
- Yan Huang,
- Yan Huang,
- Beiling Li,
- Beiling Li,
- Zhongji Meng,
- Zhongji Meng,
- Yanhang Gao,
- Yanhang Gao,
- Zhiping Qian,
- Zhiping Qian,
- Feng Liu,
- Feng Liu,
- Xiaobo Lu,
- Xiaobo Lu,
- Junping Liu,
- Junping Liu,
- Guohong Deng,
- Guohong Deng,
- Yubao Zheng,
- Yubao Zheng,
- Huadong Yan,
- Huadong Yan,
- Liang Qiao,
- Liang Qiao,
- Xiaomei Xiang,
- Xiaomei Xiang,
- Qun Zhang,
- Qun Zhang,
- Ruochan Chen,
- Ruochan Chen,
- Jinjun Chen,
- Jinjun Chen,
- Sen Luo,
- Sen Luo,
- La Gao,
- La Gao,
- Liujuan Ji,
- Liujuan Ji,
- Jing Li,
- Jing Li,
- Xinyi Zhou,
- Xinyi Zhou,
- Haotang Ren,
- Haotang Ren,
- Sihong Lu,
- Sihong Lu,
- Sumeng Li,
- Sumeng Li,
- Weituo Zhang,
- Xin Zheng,
- Xin Zheng
Affiliations
- Jing Liu
- Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Jing Liu
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Hai Li
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Hai Li
- Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Jie Xia
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Jie Xia
- Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Xianbo Wang
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Xianbo Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Yan Huang
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Yan Huang
- Department of Infectious Disease, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Hunan, China
- Beiling Li
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Beiling Li
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Zhongji Meng
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Zhongji Meng
- Department of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- Yanhang Gao
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Yanhang Gao
- Department of Hepatology, First Hospital of Jilin University, Jilin, China
- Zhiping Qian
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Zhiping Qian
- 0Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China
- Feng Liu
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Feng Liu
- 1Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Shandong, China
- Xiaobo Lu
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Xiaobo Lu
- 2Liver Disease Center, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Junping Liu
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Junping Liu
- 3Department of Infectious Diseases, Henan Provincial People's Hospital, Henan, China
- Guohong Deng
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Guohong Deng
- Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Yubao Zheng
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Yubao Zheng
- 4Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Huadong Yan
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Huadong Yan
- 5Department of Hepatology, Ningbo No. 2 Hospital, Ningbo, China
- Liang Qiao
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Liang Qiao
- Department of Gastroenterology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Xiaomei Xiang
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Xiaomei Xiang
- Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Qun Zhang
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Qun Zhang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Ruochan Chen
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Ruochan Chen
- Department of Infectious Disease, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Hunan, China
- Jinjun Chen
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Jinjun Chen
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Sen Luo
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Sen Luo
- Department of Infectious Diseases, Hubei Clinical Research Center for Precise Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of Medicine, Shiyan, China
- La Gao
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- La Gao
- Department of Hepatology, First Hospital of Jilin University, Jilin, China
- Liujuan Ji
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Liujuan Ji
- 0Department of Liver Intensive Care Unit, Shanghai Public Health Clinical Centre, Fudan University, Shanghai, China
- Jing Li
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Jing Li
- 1Department of Infectious Diseases and Hepatology, The Second Hospital of Shandong University, Shandong, China
- Xinyi Zhou
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Xinyi Zhou
- 2Liver Disease Center, First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
- Haotang Ren
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Haotang Ren
- 6State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Sihong Lu
- Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Sihong Lu
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Sumeng Li
- Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Sumeng Li
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- Weituo Zhang
- 7Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xin Zheng
- Department of Infectious Diseases, Institute of Infection and Immunology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Xin Zheng
- Chinese Chronic Liver Failure Consortium, Shanghai, China
- DOI
- https://doi.org/10.3389/fmed.2021.726950
- Journal volume & issue
-
Vol. 8
Abstract
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 <0.001). The risk of 90-day transplant-free mortality in cirrhotic patients with NLR < 6.5 increased with an increment of 23% for every unit increase in NLR (p < 0.001). The patients with NLR < 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 >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.
Keywords
- neutrophil-to-lymphocyte ratio
- short-term mortality
- cirrhosis
- acute decompensation
- acute-on-chronic liver failure
