Neutrophil to Lymphocyte Ratio (NLR) and its Correlation with Child Turcotte Pugh (CTP) Score in Prediciting Severity of Decompensated Liver Cirrhosis.

UNLABELLED

Cirrhosis is currently the 11th leading cause of death, accounting for 1.16 million deaths. Cirrhosis of the liver is usually understood to be an end-stage process in which healthy normal liver tissue is replaced by aberrant connective tissue, resulting in nodule formation. Most of the times, cirrhosis may remain clinically asymptomatic until decompensated. Systemic inflammation is now thought to have a critical role in the progression of liver injury. As a result, the adoption of a scoring system in primary care to anticipate the outcome and severity of the cirrhotic process is required since it may be utilized to initiate quick and further assessment. It is emphasized that numerous scoring systems, such as the Child-Turcotte Pugh score, which consists of five variables (bilirubin level, albumin, INR, ascites, and hepatic encephalopathy), can be used to predict the severity of liver failure. Inflammatory markers play a role in the etiology of liver disease. NLR, which is a widely available and inexpensive biomarker of systemic inflammation, can be used as a screening tool to predicting occurrence of complication and short-term mortality in patients with cirrhosis of liver. It can also be used as prognostic marker to detect decompensation in these patients.

MATERIAL

This study is conducted in 100 cirrhotic patients of age group more than 18 years for duration of one year. Participants are divided into three groups based on Child Turcotte Pugh Score (CTP). Assessment of Neutrophil to Lymphocyte Ratio is done in these groups.

OBSERVATION

Out of 100 patients,30 patients belong to Child Pugh A, 30 belongs to Child Pugh B, and 40 belongs to Child Pugh C .Child Pugh C had highest mean NLR of 9.28±4.23 as compared to patient belonging to Child Pugh B and C, although no highest threshold level was determined in this study. In Child-Pugh class C patients, the mean NLR in non survivors was 13.25±4.52 as compared to mean NLR of 6.94±1.52 in survivors. Thus an elevated mean NLR is an independent predictor of poor 1-month survival in patients with Child Pugh C.

CONCLUSION

Based on the study, it can be concluded that NLR and CTP score has a positive correlation. In Child- Pugh class C patients, NLR is an independent predictor of poor 1-month survival.