Neutrophil-lymphocyte ratio is associated with worse outcomes in patients with cirrhosis: insights from the PRO-LIVER Registry
- Autori: Tania, D.; Marzia, M.; Roberto, C.; Giulio Francesco, R.; Benedetta, D.F.; Salvatore, F.; Fabrizio, R.; Lucia, S.; Valeria, R.; Francesco, V.; Basili, ; Giuseppe Palasciano, S.; D'Alitto, F.; Ostilio Palmieri, V.; Santovito, D.; Di Michele, D.; Croce, G.; Sacerdoti, D.; Brocco, S.; Fasolato, S.; Cecchetto, L.; Bombonato, G.; Bertoni, M.; Restuccia, T.; Andreozzi, P.; Livia Liguori, M.; Perticone, F.; Caroleo, B.; Perticone, M.; Staltari, O.; Manfredini, R.; De Giorgi, A.; Averna, M.; Giammanco, A.; Granito, A.; Pettinari, I.; Marinelli, S.; Bolondi, L.; Falsetti, L.; Salvi, A.; Durante-Mangoni, E.; Cesaro, F.; Farinaro, V.; Ragone, E.; Morana, I.; Andriulli, A.; Ippolito, A.; Iacobellis, A.; Niro, G.; Merla, A.; Raimondo, G.; Maimone, S.; Cacciola, I.; Varvara, D.; Drenaggi, D.; Staffolani, S.; Picardi, A.; Vespasiani-Gentilucci, U.; Galati, G.; Gallo, P.; Davì, G.; Schiavone, C.; Santilli, F.; Tana, C.; Licata, A.; Soresi, M.; Battista Bianchi, G.; Carderi, I.; Pinto, A.; Tuttolomondo, A.; Ferrari, G.; Gresele, P.; Fierro, T.; Morelli, O.; Laffi, G.; Giulio Romanelli, R.; Arena, U.; Stasi, C.; Gasbarrini, A.; Gargovich, M.; Assunta Zocco, M.; Riccardi, L.; Elena Ainora, M.; Capeci, W.; Pio Martino, G.; Nobili, L.; Cavallo, M.; Frugiuele, P.; Greco, A.; Pietrangelo, A.; Ventura, P.; Cuoghi, C.; Marcacci, M.; Serviddio, G.; Vendemiale, G.; Villani, R.; Gargano, R.; Vidili, G.; Di Cesare, V.; Masala, M.; Delitala, G.; Invernizzi, P.; Di Minno, G.; Tufano, A.; Purrello, F.; Privitera, G.; Forgione, A.; Curigliano, V.; Senzolo, M.; Isabel Rodríguez-Castro, K.; Giannelli, G.; Serra, C.; Neri, S.; Rizzetto, M.; Debernardi Venon, W.; Svegliati Baroni, G.; Bergamaschi, G.; Masotti, M.; Costanzo, F.; Roberto Corazza, G.; Hugh Caldwell, S.; Angelico, F.; Del Ben, M.; Napoleone, L.; Polimeni, L.; Proietti, M.; Raparelli, V.; Francesco Romiti, G.; Ruscio, E.; Severoni, A.; Talerico, G.; Toriello, F.; Vestri, A.; Stefanini, L.; Rumbolà, L.; Buoninfante, G.; Maiorca, F.; Sabetta, A.; Di Cola, S.
- Anno di pubblicazione: 2025
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/706293
Abstract
Background: Liver cirrhosis (LC) is a leading global cause of morbidity and mortality, with inflammation playing a key role in disease progression and clinical complications of LC. The Neutrophil/Lymphocyte Ratio (NLR), a readily available marker of systemic inflammation, has been linked to short-term adverse outcomes in LC, but data on long-term follow-up are limited. This study aimed to investigate the relationship between NLR and long-term all-cause mortality in an unselected cohort of LC patients. Methods: Data were gathered from the Italian multicenter observational study “PRO-LIVER”. Patients with available data to calculate NLR at baseline were included. Baseline clinical determinants of NLR and the association of NRL with all-cause mortality at 2-year follow-up were evaluated. Results: From the overall cohort (n = 753), 506 patients with LC (31% female, mean age 64.8 ± 11.9 years) were included in the analysis. Median value of NLR was 2.42 (Interquartile Range [IQR]: 1.61–3.52). At baseline, patients with NLR ≥ 2.42 were more likely to have Child–Pugh B or C, hepatocellular carcinoma (HCC), or portal vein thrombosis (PVT). After a median follow-up of 21 months, 129 patients died: 44 (17%) with NLR < 2.42 and 85 (34%) with NLR ≥ 2.42 (p < 0.001). At multiple-adjusted Cox regression analysis, NLR ≥ 2.42 was independently associated with all-cause mortality (HR: 1.65; 95% CI: 1.12–2.44; p = 0.012), along with age, Child–Pugh C class, HCC and PVT. Conclusions: NLR is associated with long-term all-cause mortality in LC. NLR may serve as a potentially easily available tool to aid risk refinement in LC. Trial registration number: ClinicalTrials.gov Identifier: NCT01470547.