Evaluation of Neutrophil-to-Lymphocyte Ratio (NLR) and Its Correlation with Severity of Liver Cirrhosis Based on Child-TurcottePugh Score in a Tertiary Care Hospital, Barpeta, Assam

Abstract

BACKGROUND Liver cirrhosis (LC) is the final common pathway for all chronic liver diseases. It is a major cause of morbidity and mortality in adults globally. Systemic inflammation has now been proposed to play a crucial role in the natural history of progressive liver damage and is one of the main causes of precipitating compensated liver cirrhosis to decompensated state. Neutrophil to lymphocyte ratio (NLR) has been considered as an important inexpensive biomarker to indicate ongoing inflammation in patients with cirrhosis. The purpose of this study was to find out if there is any significant correlation between neutrophil to lymphocyte ratio and Child Turcotte Pugh score (CTP) among liver cirrhosis patients. METHODS We conducted a cross sectional study involving patients diagnosed with liver cirrhosis in Fakhruddin Ali Ahmed Medical College & Hospital, Barpeta, from November 2019 to January 2021. All patients were diagnosed based on clinical history, examination and ultrasound. The study enrolled 101 cirrhotic patients irrespective of aetiology. Total white blood cell (WBC) count, neutrophil count and lymphocyte count were recorded and neutrophil to lymphocyte count was calculated. Child Turcotte Pugh score was calculated by taking data from medical records of the patients. RESULTS Out of the 101 patients enrolled in our study, majority were males (78). A significant correlation was found between NLR and CTP score in liver cirrhosis patients. The patients with NLR < 3 showed mean CTP score of 6.1 ± 0.55, with NLR in between 3 to 6 showed CTP score of 8.2 ± 1.2 and with NLR > 6 showed mean CTP score of 11 ± 0.76 CONCLUSIONS NLR can be used as a single independent biomarker and a simpler scoring system for assessment of severity of liver cirrhosis but needs further studies and evaluation. KEYWORDS Neutrophil-to-Lymphocyte Ratio, Child-Turcotte-Pugh Score, Cirrhosis