Neutrophil-to-Lymphocyte Ratio (NLR) and its Correlation with Severity of Decompensated Liver Cirrhosis based on Child-Turcotte Pugh (CTP) Score

Abstract

Introduction: Neutrophil-to-Lymphocyte Ratio or NLR is a ratio used as a marker for ongoing inflammation process and is independently related to poor clinical outcomes among liver cirrhosis patients. Aim: To determine any significant correlation between NLR and Child-Turcotte Pugh (CTP) score among decompensated liver cirrhosis patients in a tertiary referral centre in Medan, Indonesia. Materials and Methods: The cross-sectional study involved patients diagnosed with liver cirrhosis in Haji Adam Malik General Hospital, Medan, Indonesia between May 2016-May 2017. The study enrolled 54 cirrhotic patients, regardless of aetiologic agent. CTP score was fulfilled by using two methods, bilirubin, albumin, and INR was noted from medical record registry and the rest, ascites and encephalopathy, were assessed using physical examination and interview process on the same day of the patient admission. Spearman correlation test was performed to determine the correlation between two variables, while the demographic characteristic was presented in a single table with mean or median and standard deviation in it. Results: A significant correlation between NLR and CTP score was obtained (p=0.008) and it was positively correlated (r=0.326). Conclusion: Shifting use of CTP score to NLR ratio still needs further study to acknowledge its potential as mortality and prognosis predictor independently.

Keywords

• hepatic failure
• inflammation
• leukocyte