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. 2025 May 26;25(1):404.
doi: 10.1186/s12876-025-03991-z.

Neutrophil-derived ratios as predictors of short-term mortality in HBV-associated decompensated cirrhosis

Yang Xiang  1 , WeiLin Mao  2
Affiliations

Neutrophil-derived ratios as predictors of short-term mortality in HBV-associated decompensated cirrhosis

Yang Xiang et al. BMC Gastroenterol. .

Abstract

Background: Hepatitis B virus-associated decompensated cirrhosis (HBV-DC) is recognized as a critical illness with an increased risk of short-term mortality. Neutrophil-derived ratios, including neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-albumin ratio, neutrophil-to-high-density lipoprotein-cholesterol ratio, neutrophil-to-hemoglobin ratio, and neutrophil-to-platelet ratio, have emerged as potential prognostic markers in various liver diseases. The present study aimed to determine the effectiveness of these neutrophil-derived ratios for prediction of mortality in patients with HBV-DC.

Methods: We conducted a retrospective analysis of HBV-DC patients at our hospital between April 2022 and April 2024. The study endpoint was the 30-day mortality rate. These neutrophil-derived ratios were calculated from data obtained during routine laboratory tests on admission. Disease severity was assessed using the Model for End-Stage Liver Disease (MELD) score. Multivariate regression analyses and receiver operating characteristic (ROC) curve analyses were conducted.

Results: The study investigated 160 HBV-DC patients, of whom 23 (14.4%) experienced mortality within 30 days. Non-survivors exhibited markedly higher values for neutrophil-derived ratios than survivors. All neutrophil-derived ratios were associated with mortality in univariate analyses, but only NLR and MELD score remained as independent predictors of mortality in multivariate analyses. In the ROC analyses, NLR showed a similar prognostic value to MELD score. Moreover, both NLR and MELD score had high specificity for prediction of mortality in HBV-DC patients.

Conclusions: Among neutrophil-derived ratios, NLR stands out as a simple and reliable predictor of mortality in HBV-DC patients.

Keywords: Decompensated cirrhosis; Hepatitis B virus; Mortality; Neutrophil-derived ratios; Predictor.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was performed according to the Declaration of Helsinki, and the procedures were approved by the Ethics Committee of The First Affiliated Hospital of the Medical College at Zhejiang University in China (No. 2021-22). Due to the retrospective design of this study, the need for written informed consent was waived by the ethics committee. Competing interests: The authors declare no competing interests. Consent for publication: Not applicable.

Figures

Fig. 1
Fig. 1
Flowchart of the participant selection
Fig. 2
Fig. 2
Scatter plots of the relationships between MELD score and neutrophil-derived ratios. The correlations with MELD score in HBV-DC patients were: (A) NLR (r = 0.215, p = 0.006); (B) NAR (r = 0.302, p < 0.001); (C) NHR (r = 0.460, p < 0.001); (D) NHBR (r = 0.201, p = 0.011) and (E) NPR (r = 0.420, p < 0.001)
Fig. 3
Fig. 3
ROC curve analysis of the MELD score, NLR, and the combination of MELD score and NLR for predicting mortality in HBV-DC patients
See this image and copyright information in PMC

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