ArticleShock (Augusta, Ga.)2018
Neutrophil-to-Lymphocyte Ratio Predicts Death in Acute-on-Chronic Liver Failure Patients Admitted to the Intensive Care Unit: A Retrospective Cohort Study.
Article in Shock (Augusta, Ga.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis.Canadian journal of gastroenterology & hepatology · 2022Pooled it
- Neutrophil to lymphocyte ratio and albumin bilirubin grade in hepatocellular carcinoma: A systematic review.World journal of gastroenterology · 2020Pooled it
- Beyond a Single Snapshot: Inflammatory Markers in Acute-on-chronic Liver Failure.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Neutrophil-to-lymphocyte ratio in acute decompensation of advanced chronic liver disease and acute-on-chronic liver failure: prognostic significance by etiology.Clinical and experimental hepatology · 2026Article
- Dynamic inflammation-based prognostication in acute-on-chronic liver failure: The COSSH-CAR model as a step forward in personalized risk stratification.World journal of hepatology · 2026Article
- The prognostic nutritional index vs. MELD for short-term mortality in critically ill liver disease: a retrospective multi-cohort study.Frontiers in nutrition · 2026Article
- Risk factors for the development of cirrhosis within 1-year in non-cirrhotic patients with HBV- related acute-on-chronic liver failure.Frontiers in medicine · 2026Article
- Acute versus acute-on-chronic liver failure: comparative analysis of clinical outcomes in Beijing, China.BMC gastroenterology · 2025Article
- Neutrophil-derived ratios as predictors of short-term mortality in HBV-associated decompensated cirrhosis.BMC gastroenterology · 2025Article
- Potential therapies for acute-on-chronic liver failure.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Article
- Predictive value of neutrophil-to-lymphocyte ratio and MELD score for short-term survival of patients with HBV-DeCi.Biomarkers in medicine · 2025Article
- Cardiometabolic shock: understanding the final turns of the downward spiral.Frontiers in cardiovascular medicine · 2025Review
- Low platelet to high-density lipoprotein ratio predicts poor short-term prognosis in hepatitis B-related acute-on-chronic liver failure.BMC infectious diseases · 2024Article
- Prognostic value of neutrophil-to-lymphocyte ratio in end-stage liver disease: A meta-analysis.World journal of hepatology · 2024Article
- Circulating neutrophil anti-pathogen dysfunction in cirrhosis.JHEP reports : innovation in hepatology · 2023Review
- The Value of Neutrophil-to-Lymphocyte Ratio to Identify Bacterial Infection and Predict Short-Term Mortality in Patients with Acutely Decompensated Cirrhosis.Diagnostics (Basel, Switzerland) · 2023Article
- Progress on clinical prognosis assessment in liver failure.Liver research (Beijing, China) · 2023Review
- Low lymphocyte-to-monocyte ratio, calcitriol level, and CD206 level predict the development of acute-on-chronic liver failure in patients cirrhosis with acute decompensation.Journal of the Chinese Medical Association : JCMA · 2023Article
- Utility of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting acute-on-chronic liver failure survival.Open life sciences · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. Although inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF. We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded. Of the total, 75 patients had ACLF. The 90-day mortality rate was 53%. ACLF patients displayed higher NLR values in comparison with cirrhotic patients without ACLF throughout the ICU stay. NLR proved more elevated in nonsurvivors ACLF patients, with mortality correlating with increasing quartiles of NLR. On multivariable Cox regression analysis, NLR was found to be a predictor of mortality along with the Sequential Organ Failure Assessment (SOFA) score and mechanical ventilation requirement. The model for end-stage liver disease (MELD) score was not predictive of 90-days mortality. Performance analysis revealed an area under curve of 0.71 [95% confidence interval: 0.59-0.82] regarding NLR capacity to predict 90-days mortality. When including NLR, SOFA score, and mechanical ventilation requirement into the final model, the area under curve was significantly higher (0.81 [95% confidence interval: 0.72-0.91]).These findings suggest that NLR is associated with mortality in ACLF patients admitted to the ICU. Combining NLR, SOFA score, and the need for mechanical ventilation could be a useful prognostic tool to identify ACLF patients at a higher risk of mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.