Correlation of Neutrophil-to-Lymphocyte Ratio with Severity of Chronic Liver Disease Based on Child-Turcotte-Pugh and MELD-Na Score.

INTRODUCTION

In recent times, neutrophil-to-lymphocyte ratio (NLR) has garnered interest from all over the world as a multisystemic marker for ongoing inflammatory processes. It has been found to be independently related to poor clinical outcomes among patients with liver cirrhosis due to any cause.

AIM

To determine any significant correlation between NLR with Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD)-Na score among patients with decompensated liver cirrhosis in a tertiary referral center in Ahmedabad, India.

MATERIALS AND METHODS

The cross-sectional study involved patients diagnosed with liver cirrhosis at SMS Multispeciality Hospital, Dr. M.K. Shah Medical College and Research Centre in March 2023. The study enrolled 16 cirrhotic patients, regardless of the etiologic agent. The CTP score was fulfilled by using two methods; bilirubin, albumin and international normalized ratio (INR) were noted from medical record registry, while ascites and encephalopathy were assessed using interview and physical examination on the day of patient admission. MELD-Na score was calculated by an online calculator after collecting data on all the patient's serum bilirubin, creatinine, sodium levels, and INR on the day of admission. The Spearman correlation test was performed to determine the correlation between two sets of variables, while the demographic characteristics were presented in a single table with mean or median and standard deviations.

RESULTS

A significant correlation between NLR and CTP score was obtained ( = 0.002), and it was positively correlated ( = 0.722). No significant correlation between NLR and MELD-Na could be established with a -value = 0.149 and = 0.378.

CONCLUSION

The NLR ratio may be used as an independent parameter to prognosticate the severity of decompensated liver disease. However, it still needs further study to acknowledge its potential.