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

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Author(s)
Jung Hee KimSung-Eun Kim,Do-Seon SongHee-Yeon KimEileen L. YoonTae-Hyung KimYoung-Kul JungKi Tae SukBaek-Gyu JunHyung-Joon YimJung-Hyun KwonSung-Won LeeSeong-Hee KangMoon-Young KimSoung-Won JeongJae-Young JangJeong-Ju YooSang-Gyune KimYoung-Joo JinGab-Jin CheonByung-Seok KimYeon Seok SeoHyung-Su KimDong-Hyun SinnWoo-Jin ChungHwi Young KimHan Ah LeeSeung-Woo NamIn-Hee KimJung-Il SuhJi-Hoon KimHee-Bok ChaeJoo-Hyun SohnJu-Yeon ChoYoon-Jun KimJin-Mo YangJung-Gil ParkWon KimHyun-Chin ChoDong Joon Kim
Keimyung Author(s)
Chung, Woo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Clin Med
Issued Date
2022
Volume
11
Issue
9
Keyword
platelet-to-white blood cell ratioacute-on-chronic liver failureliver cirrhosisacute decompensationadverse outcomes
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.
Keimyung Author(s)(Kor)
정우진
Publisher
School of Medicine (의과대학)
Citation
Jung Hee Kim et al. (2022). Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration. J Clin Med, 11(9), 2463. doi: 10.3390/jcm11092463
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/11/9/2463
DOI
10.3390/jcm11092463
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44325
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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