scholarly journals Relationship Between Platelet to White Blood Cell Ratio and 30-Day Prognosis of Patients with Acute-on-Chronic Liver Failure

2021 ◽  
Vol 21 (9) ◽  
Author(s):  
Xiang Xu ◽  
Chen Li ◽  
Jing Chen ◽  
Xiaoyan Liu ◽  
Haibin Su ◽  
...  
Keyword(s):  
Survival Rate ◽  
Blood Cell ◽  
Liver Failure ◽  
White Blood Cell ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Cox Models ◽  
Factors Affecting ◽  
Cell Ratio ◽  
The Relationship

Background: Acute-on-chronic liver failure (ACLF) is always associated with thrombocytopenia or leukocytosis. Therefor the platelet to white blood cell ratio (PWR) in ACLF patients is always reduced. Objectives: Here, we assessed the relationship between PWR and prognosis in ACLF patients. Methods: A retrospective cohort of 415 patients, including 100 patients that were diagnosed of chronic hepatitis B, 104 patients suffered of HBV-related liver cirrhosis and 211 patients suffered of HBV-related ACLF, was investigated. Univariate and multivariate COX models were used to investigate the relationship between PWR and 30-day survival in patients with ACLF. Factors affecting PWR in ACLF patients were also analysed using logistic regression analysis. Results: At baseline, the platelet count in patients with HBV-related ACLF was significantly lower than that in patients with CHB and patients suffered of HBV-related cirrhosis. The PWR value was much higher in the survivors of ACLF than in ACLF patients who died. PWR, age, total bilirubine, prothrombin activity, and aspartate transaminase were independent predictors of the 30-day survival rate of ACLF patients. We also found that ascites and infection were independent factors related to the decrease of PWR in ACLF patients. Conclusions: The PWR value was significant declined in ACLF patients. And it was independent risk factors for the survival rate of those patients.

scholarly journals Low Platelet to White Blood Cell Ratio Indicates Poor Prognosis for Acute-On-Chronic Liver Failure

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Yusheng Jie ◽  
Jiao Gong ◽  
Cuicui Xiao ◽  
Shuguang Zhu ◽  
Wenying Zhou ◽  
...  
Keyword(s):  
Liver Disease ◽  
Mortality Rate ◽  
Blood Cell ◽  
Liver Failure ◽  
White Blood Cell ◽  
Chronic Liver ◽  
Healthy Controls ◽  
Chronic Liver Failure ◽  
Time Activity ◽  
Cell Ratio

Background. Platelet to white blood cell ratio (PWR) was an independent prognostic predictor for outcomes in some diseases. However, the prognostic role of PWR is still unclear in patients with hepatitis B related acute-on-chronic liver failure (ACLF). In this study, we evaluated the clinical performances of PWR in predicting prognosis in HBV-related ACLF. Methods. A total of 530 subjects were recruited, including 97 healthy controls and 433 with HBV-related ACLF. Liver function, prothrombin time activity (PTA), international normalized ratio (INR), HBV DNA measurement, and routine hematological testing were performed at admission. Results. At baseline, PWR in patients with HBV-related ACLF (14.03 ± 7.17) was significantly decreased compared to those in healthy controls (39.16 ± 9.80). Reduced PWR values were clinically associated with the severity of liver disease and the increased mortality rate. Furthermore, PWR may be an inexpensive, easily accessible, and significant independent prognostic index for mortality on multivariate analysis (HR = 0.660, 95% CI: 0.438–0.996, p=0.048) as well as model for end-stage liver disease (MELD) score. Conclusions. The PWR values were markedly decreased in ACLF patients compared with healthy controls and associated with severe liver disease. Moreover, PWR was an independent prognostic indicator for the mortality rate in patients with ACLF. This investigation highlights that PWR comprised a useful biomarker for prediction of liver severity.

scholarly journals Platelet to white blood cell ratio predicts 30-day postoperative infectious complications in patients undergoing radical nephrectomy for renal malignancy

2017 ◽  
Vol 11 (11) ◽  
pp. E414-20 ◽  
Author(s):  
Alaina Garbens ◽  
Christopher J.D. Wallis ◽  
Georg Bjarnason ◽  
Girish S. Kulkarni ◽  
Avery B. Nathens ◽  
...  
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Radical Nephrectomy ◽  
External Validation ◽  
Infectious Complications ◽  
Bleeding Complications ◽  
Improvement Program ◽  
Cell Ratio ◽  
Increased Risk ◽  
The Relationship

Introduction: We sought to examine the relationship between preoperative platelet to white blood cell ratio (PLT/WBC), a hematological marker of the systemic inflammatory response, and postoperative infectious complications following radical nephrectomy for localized renal cell carcinoma.Methods: We performed a retrospective cohort study of patients treated with radical nephrectomy for localized kidney cancer between January 1, 2005 and December 31, 2014 (n=6235) using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Univariate and multivariate analyses were used to assess the association between PLT/ WBC ratio and 30-day infectious complications, including surgical site infection, urinary tract infection (UTI), pneumonia, and sepsis. Secondarily, we examined major complications and bleeding requiring transfusion.Results: A lower PLT/WBC ratio was associated with an increased risk of sepsis, pneumonia, and UTI rates (p<0.05 for all). Furthermore, there was a significant trend of decreasing rates of sepsis and pneumonia with increasing PLT/WBC ratio across quintiles (p<0.05 for all). On multivariate analysis, patients with the lowest PLT/WBC ratios (Quintile 1) had a two-fold risk of having a postoperative infectious complication compared to patients in the highest quintile (odds ratio [OR] 2.01; 95% confidence interval [CI] 1.42–2.86; p<0.0001). Patients in Quintile 5 had a higher risk of requiring blood transfusion than those in Quintiles 2‒4 (p<0.05 for all).Conclusions: The PLT/WBC ratio represents a widely available and novel index to predict risk of infectious and bleeding complications in patients undergoing radical nephrectomy. External validation is required and the biological underpinning of this phenomenon requires further study

scholarly journals Peripheral T Lymphocytes Predict the Severity and Prognosis in Patients with HBV-Related Acute-On-Chronic Liver Failure

2020 ◽  
Author(s):  
Feng Zhang ◽  
Feixia Wang ◽  
Weiwei Sun ◽  
Qian Xiao ◽  
Chongfeng Liang ◽  
...  
Keyword(s):  
T Cells ◽  
Immune System ◽  
T Lymphocytes ◽  
Hepatitis B ◽  
Blood Cell ◽  
Liver Failure ◽  
White Blood Cell ◽  
Treg Cells ◽  
Blood Cell Count ◽  
Chronic Liver Failure

Abstract Background Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening syndrome with high mortality. Biomarkers are urgently needed to predict the prognosis of HBV-ACLF. Recent evidence suggests a key role for immune system in the pathology of HBV-ACLF. Here, we analyzed the correlation between peripheral blood T lymphocytes and the severity and prognosis in HBV-ACLF patients.Methods Sixty-six patients with HBV-ACLF received conventional medical treatments for four weeks. Twenty-three healthy subjects and 23 HBV patients were enrolled for comparison. We determined white blood cell count, lymphocytes, CD3+, CD4+ and CD8+ T cells, and CD4+CD25+ Treg cells in the blood of all subjects. Their associations with laboratory parameters before or after treatments were statistically analyzed.Results The results showed that compare normal subjects and chronic hepatitis B patients, HBV-ACLF patients had significantly increased white blood count, CD4+ T cells and decreased lymphocytes, CD3+ T cells and Treg cells. Correlation analysis showed that white blood cell, lymphocytes and peripheral T lymphocytes were correlated with PTA and MELD scores. After treatment, white blood cell, lymphocytes, and peripheral T lymphocytes were also correlated with PTA and MELD scores. Additionally, TBIL, ALT, INR, MELD and white blood cell count were potential prognostic criteria for HBV-ACLF patients. In conclusion, HBV-ACLF patients had depletion and dysfunction of immune system. Changes of peripheral T lymphocytes were closely related to the pathogenesis and prognosis of disease.Conclusions Our results may contribute to predict the severity of HBV-ACLF, and provide a prognosis response to improve the treatment of HBV-ACLF.

scholarly journals The Comparative Efficacy and Safety of Entecavir and Lamivudine in Patients with HBV-Associated Acute-on-Chronic Liver Failure: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11
Author(s):  
Jiao Yang ◽  
Hang Sun ◽  
Qi Liu
Keyword(s):  
Survival Rate ◽  
Liver Failure ◽  
Meta Analysis ◽  
Survival Rates ◽  
Term Treatment ◽  
Chronic Liver ◽  
Efficacy And Safety ◽  
Chronic Liver Failure ◽  
Long Term Treatment

Background.Currently, both of entecavir and lamivudine are effective for patients with HBV-associated acute-on-chronic liver failure (ACLF). However, there is no consensus on the efficacy of entecavir versus lamivudine for patients with HBV-associated ACLF. The aim of the study was to compare the efficacy and safety of entecavir with that of lamivudine for HBV-associated ACLF patients.Methods.Publications on entecavir versus lamivudine in HBV-associated ACLF patients were comprehensively identified. Odds ratio and mean difference were used to measure the effect.Results.Ten studies, totaling 1254 patients, were eligible. No significant differences between the two drugs presented in the 1-, 2-, 3-, or 6-month survival rates. However, after 12 months of treatment, patients prescribed entecavir had a statistically higher survival rate (p=0.008) and lower total bilirubin (p<0.0001) and alanine aminotransferase (p=0.04) levels compared to patients prescribed lamivudine. More patients achieved HBV negative levels when taking entecavir as measured at 1-, 3-, and 12-month time points and had a lower rate of HBV recurrence.Conclusion.While entecavir and lamivudine are both relatively safe and well tolerated, entecavir was more efficacious in terms of survival rate and clinical improvement in long-term treatment. Further prospective randomized controlled trials are needed to validate these results.

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