Lymphocyte-monocyte ratio at admission predicts possible outcomes in patients with acute-on-chronic liver failure

Background The lymphocyte-monocyte ratio (LMR) in the peripheral blood is suggested to be a potential biomarker for predicting the clinical outcomes of several diseases. We aimed to evaluate the relative efficiency of LMR for predicting 3-month mortality in patients with acute-on-chronic liver failure (AoCLF). Patients and methods In this study, 74 chronic hepatitis B patients, 90 AoCLF patients, and 70 healthy controls were followed up for 4 months. The primary endpoint was 3-month in-hospital mortality. Hematological and virological parameters as well as liver biochemistry were determined using blood samples ordered upon admission. A panel of clinical and biochemical variables were analyzed for potential associations with outcomes using Cox proportional hazards and multiple regression models. Results A significantly lower LMR was detected in AoCLF patients than in healthy controls and chronic hepatitis B groups (both P = 0.001). The LMR inversely correlated with model for end-stage liver disease scores, and a lower LMR was associated with increased 3-month mortality. Multivariate analysis suggested that both LMR and model for end-stage liver disease scores were independent predictors of 3-month mortality (P < 0.01). Conclusion A low LMR measured at admission is predictive of a poor prognosis in AoCLF patients. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.