Elevated neutrophil-to-hemoglobin ratio as an indicator of poor survival in hepatitis B virus-related decompensated cirrhosis

Abstract

Aim: Our goal was to explore the prognostic value of the neutrophil-to-hemoglobin ratio (NHR) in HBV-related decompensated cirrhosis (HBV-DC) patients. Methods: 172 HBV-DC patients were enrolled. Multivariate analyses were used to identify risk factors influencing 30-day mortality. Results: The 30-day mortality was 12.8% (22/172). nonsurvivors exhibited a higher NHR than survivors. On multivariate analysis, NHR and model for end-stage liver disease (MELD) score were the only independent predictors of mortality. Notably, the predictive capabilities of NHR were found to be comparable to those of the MELD score. Conclusion: High NHR was associated with poor prognosis in HBV-DC patients, and NHR can serve as an effective and readily available indicator for the prediction of mortality in these patients.

Article highlights

Background

• Blood cell-based indexes have widely accepted as useful indicators for diagnosis and prognosis in many clinical diseases.

• Neutrophil-to-hemoglobin ratio (NHR), an indicator of inflammation, has emerged as a new marker of in-hospital mortality.

• Our goal was to explore the prognostic value of the NHR in HBV-related decompensated cirrhosis (HBV-DC) patients.

Materials & methods

• 172 HBV-DC patients were enrolled.

• Multivariate analyses were used to identify potential risk factors influencing 30-day mortality.

Results

• NHR was higher in nonsurvivors than in survivors in HBV-DC.

• Multivariate analysis identified NHR and Model for End-Stage Liver Disease (MELD) score as independent prognostic predictors.

• The predictive value of NHR was similar to that of MELD score.

Conclusion

• NHR has potential as a reliable tool for prediction of poor prognosis in HBV-DC patients.

Keywords: :

• anemia
• decompensated cirrhosis
• hepatitis B virus
• neutrophil-to-hemoglobin ratio
• prognostic marker

Author contribution

T Zhang designed and performed the experiments, analyzed the data and wrote the manuscript. WL Mao analyzed the data and revised the manuscript; and all authors have read and approved the final manuscript.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, stock ownership or options and expert testimony.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval (Ethics Committee of the Shengzhou People's Hospital and The First Affiliated Hospital of the Medical College at Zhejiang University in China (approval number: 2024[08] and 2018[598])). and/or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations.

In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.