Evaluation of Neutrophil-to-Lymphocyte Ratio (NLR) and Its Correlation with Severity of Liver Cirrhosis Based on Child-Turcotte- Pugh Score in a Tertiary Care Hospital, Barpeta, Assam

Author(s): Paresh Kumar Sarma1, Prosenjit Roy2, Nekib Uddin Ahmed3, Hillol Sarkar4, Lindoak Rongpi5

Liver cirrhosis (LC) is the final common pathway for all chronic liver diseases. It is
a major cause of morbidity and mortality in adults globally. Systemic inflammation
has now been proposed to play a crucial role in the natural history of progressive
liver damage and is one of the main causes of precipitating compensated liver
cirrhosis to decompensated state. Neutrophil to lymphocyte ratio (NLR) has been
considered as an important inexpensive biomarker to indicate ongoing
inflammation in patients with cirrhosis. The purpose of this study was to find out
if there is any significant correlation between neutrophil to lymphocyte ratio and
Child Turcotte Pugh score (CTP) among liver cirrhosis patients.
We conducted a cross sectional study involving patients diagnosed with liver
cirrhosis in Fakhruddin Ali Ahmed Medical College & Hospital, Barpeta, from
November 2019 to January 2021. All patients were diagnosed based on clinical
history, examination and ultrasound. The study enrolled 101 cirrhotic patients
irrespective of aetiology. Total white blood cell (WBC) count, neutrophil count and
lymphocyte count were recorded and neutrophil to lymphocyte count was
calculated. Child Turcotte Pugh score was calculated by taking data from medical
records of the patients.
Out of the 101 patients enrolled in our study, majority were males (78). A
significant correlation was found between NLR and CTP score in liver cirrhosis
patients. The patients with NLR < 3 showed mean CTP score of 6.1 ± 0.55, with
NLR in between 3 to 6 showed CTP score of 8.2 ± 1.2 and with NLR > 6 showed
mean CTP score of 11 ± 0.76
NLR can be used as a single independent biomarker and a simpler scoring system
for assessment of severity of liver cirrhosis but needs further studies and