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Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deteriorationopen access

Authors
Kim, Jung-HeeKim, Sung-EunSong, Do-SeonKim, Hee-YeonYoon, Eileen L.Kim, Tae-HyungJung, Young-KulSuk, Ki-TaeJun, Baek-GyuYim, Hyung-JoonKwon, Jung-HyunLee, Sung-WonKang, Seong-HeeKim, Moon-YoungJeong, Soung-WonJang, Jae-YoungYoo, Jeong-JuKim, Sang-GyuneJin, Young-JooCheon, Gab-JinKim, Byung-SeokSeo, Yeon-SeokKim, Hyung-SuSinn, Dong-HyunChung, Woo-JinKim, Hwi-YoungLee, Han-AhNam, Seung-WooKim, In-HeeSuh, Jung-IlKim, Ji-HoonChae, Hee-BokSohn, Joo-HyunCho, Ju-YeonKim, Yoon-JunYang, Jin-MoPark, Jung-GilKim, WonCho, Hyun-ChinKim, Dong-Joon
Issue Date
May-2022
Publisher
MDPI AG
Keywords
platelet-to-white blood cell ratio; acute-on-chronic liver failure; liver cirrhosis; acute decompensation; adverse outcomes
Citation
Journal of Clinical Medicine, v.11, no.9
Indexed
SCIE
SCOPUS
Journal Title
Journal of Clinical Medicine
Volume
11
Number
9
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/60934
DOI
10.3390/jcm11092463
Abstract
Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 +/- 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9-15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR <= 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.
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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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