Journal of Clinical Medicine (Apr 2022)
Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration
- Jung Hee Kim,
- Sung-Eun Kim,
- Do-Seon Song,
- Hee-Yeon Kim,
- Eileen L. Yoon,
- Tae-Hyung Kim,
- Young-Kul Jung,
- Ki Tae Suk,
- Baek-Gyu Jun,
- Hyung-Joon Yim,
- Jung-Hyun Kwon,
- Sung-Won Lee,
- Seong-Hee Kang,
- Moon-Young Kim,
- Soung-Won Jeong,
- Jae-Young Jang,
- Jeong-Ju Yoo,
- Sang-Gyune Kim,
- Young-Joo Jin,
- Gab-Jin Cheon,
- Byung-Seok Kim,
- Yeon Seok Seo,
- Hyung-Su Kim,
- Dong-Hyun Sinn,
- Woo-Jin Chung,
- Hwi Young Kim,
- Han Ah Lee,
- Seung-Woo Nam,
- In-Hee Kim,
- Jung-Il Suh,
- Ji-Hoon Kim,
- Hee-Bok Chae,
- Joo-Hyun Sohn,
- Ju-Yeon Cho,
- Yoon-Jun Kim,
- Jin-Mo Yang,
- Jung-Gil Park,
- Won Kim,
- Hyun-Chin Cho,
- Dong Joon Kim
Affiliations
- Jung Hee Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea
- Sung-Eun Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea
- Do-Seon Song
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Hee-Yeon Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Eileen L. Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Tae-Hyung Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
- Young-Kul Jung
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
- Ki Tae Suk
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea
- Baek-Gyu Jun
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, Korea
- Hyung-Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
- Jung-Hyun Kwon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Sung-Won Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Seong-Hee Kang
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, Korea
- Moon-Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
- Soung-Won Jeong
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, Korea
- Jae-Young Jang
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, Korea
- Jeong-Ju Yoo
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
- Sang-Gyune Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
- Young-Joo Jin
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22212, Korea
- Gab-Jin Cheon
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Korea
- Byung-Seok Kim
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Korea
- Yeon Seok Seo
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
- Hyung-Su Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea
- Dong-Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, Korea
- Woo-Jin Chung
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Korea
- Hwi Young Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea
- Han Ah Lee
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea
- Seung-Woo Nam
- Department of Internal Medicine, National Medical Center, Seoul 04564, Korea
- In-Hee Kim
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju 54896, Korea
- Jung-Il Suh
- Department of Gastroenterology, Dongguk University College of Medicine, Kyongju 38067, Korea
- Ji-Hoon Kim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea
- Hee-Bok Chae
- Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju 28644, Korea
- Joo-Hyun Sohn
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Ju-Yeon Cho
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Korea
- Yoon-Jun Kim
- Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea
- Jin-Mo Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Jung-Gil Park
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, Korea
- Won Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Korea
- Hyun-Chin Cho
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju 52727, Korea
- Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea
- DOI
- https://doi.org/10.3390/jcm11092463
- Journal volume & issue
-
Vol. 11,
no. 9
p. 2463
Abstract
Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.
Keywords
- platelet-to-white blood cell ratio
- acute-on-chronic liver failure
- liver cirrhosis
- acute decompensation
- adverse outcomes