ANALYSIS OF NEUTROPHIL-TO-LYMPHOCYTE RATIO AND C-REACTIVE PROTEIN IN CIRRHOTIC PATIENTS WITH BACTERIAL, FUNGAL, AND VIRAL INFECTIONS: A CROSS-SECTIONAL STUDY

Introduction and Objectives

Patients with liver cirrhosis and infections may develop Acute-on-Chronic Liver Failure (ACLF), significantly reducing survival. Neutrophil-to-Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) are key inflammatory biomarkers.

This study aimed to analyze NLR and CRP levels in cirrhotic patients, categorizing them into three groups: those with “bacterial infections”, those with “no infections”, and those with “other infections” (fungal/viral).

Materials and Methods

A retrospective, analytical study was conducted on cirrhotic patients from 2023-2024. Data analyzed included age, sex, Child-Pugh score, and median NLR and CRP, stratified into three groups. Statistical analysis involved Chi-square, Kruskal-Wallis, and Dunn's post-hoc tests.

Results

Of 220 patients, 66.4% (n=146) were male, with a median age of 61. Child C scores were prevalent in “bacterial infection” patients (63.8%, n=37); Child B dominated in “other infections” (41.2%, n=14) and “no infections” (49.2%, n=63), with p<0.001. Among 162 patients with CRP data, the “bacterial infection” group (n=47) had a median CRP of 59.8 (IQR=34.79–82.8), significantly higher than the "no infection" (n=87): 14.2 (IQR: 6-34) and “other infections” (n=28): 26.94 (4.26-60.4) groups (p<0.001). The bacterial group also showed a higher median NLR [6.17 (IQR=3.19-10.77)] versus “no infections” [3.53(1.99-6.05)] and other infections [3.97 (2.44-11.27)] (p=0.002), with statistical significance between bacterial and no infection groups.

Conclusions

Cirrhotic patients with bacterial infections exhibited higher NLR and CRP values, especially compared to those without infections. This suggests NLR and CRP are valuable biomarkers for detecting infections in cirrhotic patients.

Conflict of interest: None