Neutrophil–lymphocyte ratio is associated with worse outcomes in patients with cirrhosis: insights from the PRO-LIVER Registry
Articolo
Data di Pubblicazione:
2025
Citazione:
Neutrophil–lymphocyte ratio is associated with worse outcomes in patients with cirrhosis: insights from the PRO-LIVER Registry / T. D'Amico, M. Miglionico, R. Cangemi, G.F. Romiti, B. De Fabrizio, S. Fasano, F. Recchia, L. Stefanini, V. Raparelli, F. Violi, S. Basili, N. Null, G. Palasciano, F. D'Alitto, V.O. Palmieri, D. Santovito, D. Di Michele, G. Croce, D. Sacerdoti, S. Brocco, S. Fasolato, L. Cecchetto, G. Bombonato, M. Bertoni, T. Restuccia, P. Andreozzi, M.L. Liguori, F. Perticone, B. Caroleo, M. Perticone, O. Staltari, R. Manfredini, A. De Giorgi, M. Averna, A. Giammanco, A. Granito, I. Pettinari, S. Marinelli, L. Bolondi, L. Falsetti, A. Salvi, E. Durante-Mangoni, F. Cesaro, V. Farinaro, E. Ragone, I. Morana, A. Andriulli, A. Ippolito, A. Iacobellis, G. Niro, A. Merla, G. Raimondo, S. Maimone, I. Cacciola, D. Varvara, D. Drenaggi, S. Staffolani, A. Picardi, U. Vespasiani-Gentilucci, G. Galati, P. Gallo, G. Davì, C. Schiavone, F. Santilli, C. Tana, A. Licata, M. Soresi, G.B. Bianchi, I. Carderi, A. Pinto, A. Tuttolomondo, G. Ferrari, P. Gresele, T. Fierro, O. Morelli, G. Laffi, R.G. Romanelli, U. Arena, C. Stasi, A. Gasbarrini, M. Gargovich, M.A. Zocco, L. Riccardi, M.E. Ainora, W. Capeci, G.P. Martino, L. Nobili, M. Cavallo, P. Frugiuele, A. Greco, A. Pietrangelo, P. Ventura, C. Cuoghi, M. Marcacci, G. Serviddio, G. Vendemiale, R. Villani, R. Gargano, G. Vidili, V. Di Cesare, M. Masala, G. Delitala, P. Invernizzi, G. Di Minno, A. Tufano, F. Purrello, G. Privitera, A. Forgione, V. Curigliano, M. Senzolo, K.I. Rodríguez-Castro, G. Giannelli, C. Serra, S. Neri, M. Rizzetto, W. Debernardi Venon, G. Svegliati Baroni, G. Bergamaschi, M. Masotti, F. Costanzo, G.R. Corazza, S.H. Caldwell, F. Angelico, M. Del Ben, L. Napoleone, L. Polimeni, M. Proietti, V. Raparelli, G.F. Romiti, E. Ruscio, A. Severoni, G. Talerico, F. Toriello, A. Vestri, L. Stefanini, L. Rumbolà, G. Buoninfante, F. Maiorca, A. Sabetta, S. Di Cola. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - (2025). [Epub ahead of print] [10.1007/s11739-025-03955-x]
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.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Cirrhosis; Inflammation; Mortality; Neutrophil–lymphocyte ratio
Elenco autori:
T. D'Amico, M. Miglionico, R. Cangemi, G.F. Romiti, B. De Fabrizio, S. Fasano, F. Recchia, L. Stefanini, V. Raparelli, F. Violi, S. Basili, N. Null, G. Palasciano, F. D'Alitto, V.O. Palmieri, D. Santovito, D. Di Michele, G. Croce, D. Sacerdoti, S. Brocco, S. Fasolato, L. Cecchetto, G. Bombonato, M. Bertoni, T. Restuccia, P. Andreozzi, M.L. Liguori, F. Perticone, B. Caroleo, M. Perticone, O. Staltari, R. Manfredini, A. De Giorgi, M. Averna, A. Giammanco, A. Granito, I. Pettinari, S. Marinelli, L. Bolondi, L. Falsetti, A. Salvi, E. Durante-Mangoni, F. Cesaro, V. Farinaro, E. Ragone, I. Morana, A. Andriulli, A. Ippolito, A. Iacobellis, G. Niro, A. Merla, G. Raimondo, S. Maimone, I. Cacciola, D. Varvara, D. Drenaggi, S. Staffolani, A. Picardi, U. Vespasiani-Gentilucci, G. Galati, P. Gallo, G. Davì, C. Schiavone, F. Santilli, C. Tana, A. Licata, M. Soresi, G.B. Bianchi, I. Carderi, A. Pinto, A. Tuttolomondo, G. Ferrari, P. Gresele, T. Fierro, O. Morelli, G. Laffi, R.G. Romanelli, U. Arena, C. Stasi, A. Gasbarrini, M. Gargovich, M.A. Zocco, L. Riccardi, M.E. Ainora, W. Capeci, G.P. Martino, L. Nobili, M. Cavallo, P. Frugiuele, A. Greco, A. Pietrangelo, P. Ventura, C. Cuoghi, M. Marcacci, G. Serviddio, G. Vendemiale, R. Villani, R. Gargano, G. Vidili, V. Di Cesare, M. Masala, G. Delitala, P. Invernizzi, G. Di Minno, A. Tufano, F. Purrello, G. Privitera, A. Forgione, V. Curigliano, M. Senzolo, K.I. Rodríguez-Castro, G. Giannelli, C. Serra, S. Neri, M. Rizzetto, W. Debernardi Venon, G. Svegliati Baroni, G. Bergamaschi, M. Masotti, F. Costanzo, G.R. Corazza, S.H. Caldwell, F. Angelico, M. Del Ben, L. Napoleone, L. Polimeni, M. Proietti, V. Raparelli, G.F. Romiti, E. Ruscio, A. Severoni, G. Talerico, F. Toriello, A. Vestri, L. Stefanini, L. Rumbolà, G. Buoninfante, F. Maiorca, A. Sabetta, S. Di Cola
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