Prognostic value of neutrophil count to albumin ratio in patients with decompensated cirrhosis

• Published in: Scientific reports Vol. 13; no. 1; p. 20759
• Main Authors: Yao, Junjie, Xu, Xianbin, Gong, Kai, Tu, Huilan, Xu, Zhaoyu, Ye, Shaoheng, Yu, Xia, Lan, Yan, Weng, Haoda, Shi, Yu
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 25-11-2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/499; 692/53; 692/699; Albumin; Albumins; Cirrhosis; Humanities and Social Sciences; Humans; Leukocytes (neutrophilic); Liver cirrhosis; Liver Cirrhosis - complications; Liver transplantation; Mortality; multidisciplinary; Multivariate analysis; Neutrophils; Observational studies; Prognosis; Retrospective Studies; ROC Curve; Science; Science (multidisciplinary); Severity of Illness Index
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-44842-9

Our study aimed to investigate the prognostic value of neutrophil count to albumin ratio (NAR) in predicting short-term mortality of patients with decompensated cirrhosis (DC). A total of 623 DC patients were recruited from a retrospective observational cohort study. They were admitted to our hospital from January 2014 to December 2015. NAR of each patient was calculated and analyzed for the association with 90-day liver transplantation-free (LT-free) outcome. The performance of NAR and the integrated model were tested by a receiver-operator curve (ROC) and C-index. The 90-day LT-free mortality of patients with DC was 10.6%. NAR was significantly higher in 90-day non-survivors than in survivors (The median: 1.73 vs 0.76,
P
 < 0.001). A threshold of 1.40 of NAR differentiated patients with a high risk of death (27.45%) from those with a low risk (5.11%). By multivariate analysis, high NAR was independently associated with poor short-term prognosis (high group: 5.07 (2.78, 9.22)). NAR alone had an area under the ROC curve of 0.794 and C-index of 0.7789 (0.7287, 0.8291) in predicting 90-day mortality. The integrated MELD–NAR (iMELD) model had a higher area under the ROC (0.872) and C-index (0.8558 (0.8122, 0.8994)) than the original MELD in predicting 90-day mortality. NAR can be used as an independent predictor of poor outcomes for patients with DC during short-term follow-up.