The association between neutrophil-to-lymphocyte ratio and ascites in cirrhosis: a retrospective cross-sectional study

Abstract

Abstract Background: Systemic inflammation and immune system dysfunction play important roles in the pathophysiology of cirrhosis. The neutrophil-to-lymphocyte ratio (NLR) is a marker associated with systemic inflammation and immune dysregulation in cirrhotic patients. NLR is inexpensive and may predict decompensation and mortality in these patients. In this study, we aimed to investigate the association between NLR and the presence of ascites as a complication in cirrhosis. Methods: A retrospective observational cross-sectional study was conducted in 61 adult cirrhotic patients without documented malignancy, systemic infection, and autoimmune diseases at our hospital between January 2015 to December 2018. NLR, presence of ascites, and all other variables were collected from the first day of presentation. Results: There were 31 patients with ascites and 30 without ascites. The mean NLRs were 2.72±1.20 and 3.53±1.51 in patients with and without ascites (p=0,022). ROC curve analysis demonstrated a NLR cut-off value of 2.70 (AUC 0.660, p=0.032). Cirrhotic patients with NLR <2.70 is 4.354 times more likely to have the presence of ascites (95% CI: 1,471-12,885, p=0.006). Conclusion: Lower neutrophil-to-lymphocyte ratio is associated with the presence of ascites in cirrhosis. Patients with NLR of <2.70 are four times more likely to have the presence of ascites. This finding supports the evidence of neutropenia in decompensated cirrhosis. Further studies are required to elucidate the prognostic utility of NLR in cirrhosis.