A nomogram for predicting prognostic value of inflammatory response biomarkers in decompensated cirrhotic patients without acute‐on‐chronic liver failure

• Published in: Alimentary pharmacology & therapeutics 2017-06, Vol.45 (11), p.1413-1426
• Main Authors: Cai, Y.‐J., Dong, J.‐J., Dong, J.‐Z., Chen, Y., Lin, Z., Song, M., Wang, Y.‐Q., Chen, Y.‐P., Shi, K.‐Q., Zhou, M.‐T.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers; Cirrhosis; Disease Progression; Female; Humans; Inflammation; Inflammation - pathology; Inflammatory response; Liver; Liver cirrhosis; Liver Cirrhosis - pathology; Liver failure; Lymphocytes; Male; Medical prognosis; Middle Aged; Monocytes; Mortality; Neutrophils; Nomograms; Prognosis; Proportional Hazards Models; ROC Curve; Survival; Time Factors
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.14046

Summary Background Inflammation plays a vital role in liver cirrhosis progression and prognosis. Aim To investigate the prognostic significance of inflammatory response markers in decompensated cirrhotic patients without acute‐on‐chronic liver failure (ACLF). Methods Independent predictors were identified using multivariate Cox model and then assembled into a nomogram to predict survival. Concordance index (C‐index) and time‐dependent receiver operating characteristics (td‐ROC) analysis were adopted to evaluate and compare the performance of nomogram, model for end‐stage liver disease (MELD) scores, MELD‐Na and Chronic Liver Failure‐consortium score for acute decompensated (CLIF‐C ADs). Results A total of 902 decompensated cirrhotic patients with different aetiologies were enrolled, with 6‐month, 1‐year and 3‐year mortality of 18.6%, 24.4% and 34.8%, respectively. The cut‐off values for neutrophil‐to‐lymphocyte ratio (NLR) and lymphocyte‐to‐monocyte ratio (LMR) determined by X‐tile program were 5.7 and 1.1 respectively. Patients with NLR>5.7 or LMR≤1.1 had significantly higher mortality (P