P-36 THE PROGNOSTIC ROLE OF NEUTROPHIL-LYMPHOCYTE RATIO IN PATIENTS WITH ALCOHOLIC HEPATITIS

Conflict of interest

No

Introduction and Objectives

The neutrophil-lymphocyte ratio (NLR) has been used as a predictor of survival in critically ill patients. However, there are scarce studies that evaluate the relationship between NLR and alcoholic hepatitis.

To determine the association between NLR with mortality and the degree of acute-on-chronic liver failure (ACLF).

Patients / Materials and Methods

Longitudinal, retrospective, observational and descriptive cohort study of a hospital center. The subjects met criteria for alcohol hepatitis established by the National Institute on Alcohol Abuse and Alcoholism. Patients with concomitant infections or conditions that could alter the NLR were excluded.

Statistical analysis was performed with the SPSS version 26 program. To compare clinical values, Student's T-test or Mann Whitney U test were performed according to the distribution of the data. The association analysis between NLR and 30-day mortality, as well as the association between NLR and ACLF degrees, were carried out using a point-biserial correlation. Cohen's d test was performed to determine the effect size.

Results and Discussion

This study included 58 patients with alcoholic hepatis (98% men). There was significant difference between patients who died within 28 days compared with those who survived (Table 1). The mean NLR value in patients who survived was approximately three times the value presented in patients who died within 28 days (p < 0.001). A gradual increase in severity-dependent NLR was identified based on the CLIF-C ACLF SCORE.

In addition, significant associations between NLR and 28-day mortality (p < 0.001), and between NLR and the degree of ACLF (p < 0.001) were found. According to Cohen's test, the effect size of the NLR was moderate (0.678).

Conclusions

The association between high NLR levels and mortality within 28 days is confirmed. Furthermore, there is an association between NLR and the severity of ACLF. Therefore, the NLR could be a useful prognostic factor in the clinical practice for alcoholic hepatitis.