Diagnostic value of dynamic changes of monocyte-to-lymphocyte ratio in acute-on-chronic hepatitis B liver failure
Objective To explore the diagnostic value of dynamic changes of monocyte/lymphocyte ratio(MLR)in the prognosis of acute-on-chronic hepatitis B liver failure(ACHBLF).Methods The study involved ACHBLF patients from January 2010 to July 2023 in the Department of Hepatology,Qilu Hospital of Shandong University.Smooth curve fitting and threshold effect analysis were used to evaluate the nonlinear relationship between MLR and 30-day mortality of ACHBLF patients.Logistic regression analysis and the Boruta algorithm were used to assess risk factors for 30-day mortality.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of MLR and the bootstrap method was used for internal validation.Results In this study,98 of the 243 individuals died within 30 days after hospitalization.MLR on the 8th day was identified as an independent risk factor for 30-day mortality of ACHBLF patients(OR=1.33,95％CI:1.01-1.75,P=0.044),which was reported to be nonlinearly associated with 30-day mor-tality.Patients with MLR＞1 on the 8th day showed a higher risk of mortality than those with MLR ≤ 1(P＜0.001).ROC curve showed that combination of MLR on the 8th day and the model for end-stage liver disease(MELD)score presented the area under the ROC of 0.775(95％CI:0.69-0.86).Conclusion MLR＞1 on the 8th day predicts poor 30-day prognosis in ACHBLF patients,and monitoring the dynamic changes of MLR is essential for the treatment of ACH-BLF.
Acute-on-chronic hepatitis B liver failureMonocyte/lymphocyte ratioPrognosisRisk factor
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