| Abstrakt: |
Background/Aims Complete blood count is a simple analysis providing information about systemic inflammation. Many derived indices have emerged as useful prognostic markers in various diseases, including predicting mortality in decompensated cirrhosis. This study aimed to assess the utility of these indices in predicting recompensation following an initial decompensation event in cirrhosis. Methods Cirrhotic patients admitted between 2000 and 2021 for a first decompensation event (ascites, variceal hemorrhage, or hepatic encephalopathy) were retrospectively included. The calculated inflammatory indices included Neutrophil-to-Lymphocyte Ratio (NLR), Neutrophil-to-Platelet Ratio (NPR), Monocyte-to-Lymphocyte Ratio (MLR), Monocyte-to-Platelet Ratio (MPR), and the Systemic Inflammation Response Index (SIRI=neutrophils×monocytes / lymphocytes). Receiver Operating Characteristic (ROC) analysis and area under the curve (AUC) were used to evaluate the predictive performance of these scores in cirrhosis recompensation. Results Ninety-nine patients were included (mean age 61±11 years, sex ratio 0.77). Decompensation events included ascites (n=81), variceal hemorrhage (n=13), and hepatic encephalopathy (n=11). Over a median follow-up of 22 months [13–88 months], 45 patients (45.5%) achieved recompensation. Among the indices, NLR and NPR demonstrated superior predictive performance, with AUCs of 0.96 and 0.91, respectively (p<0.001). An NLR threshold of 2.63 achieved 92% sensitivity, 96% specificity, and 94% diagnostic accuracy (DA). Similarly, NPR ≤0.05 showed 92% sensitivity, 78% specificity, and 85% DA. In contrast, MLR, MPR, and SIRI showed moderate predictive performance. MLR ≤0.37 had 58% sensitivity, 89% specificity, and 74% DA. MPR ≤6.56×10^-3 demonstrated 62% sensitivity, 77% specificity, and 70% DA. SIRI ≤1.18 exhibited 65% sensitivity, 95% specificity, and 81% DA. Conclusion Complete blood count-derived inflammatory indices, particularly NLR and NPR, are reliable predictors of cirrhosis recompensation following an initial decompensation event. Their integration into clinical practice is encouraged to enhance risk stratification. [ABSTRACT FROM AUTHOR] |
