Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration

Kim, Jung-Hee; Kim, Sung-Eun; Song, Do-Seon; Yoon, Eileen L.; Kim, Tae Hyung; Jung, Young Kul; Suk, Ki Tae; Jun, Baekgyu; Yim, Hyung-Joon; Kwon, Jung-Hyun; Lee, Sung-Won; Kang, Sung Hak; Kim, Moon-Young; Jeong, Soung-Won; Jang, Jae-Young; Yoo, Jeong‐Ju; Kim, Sang Gyune; Jin, Young–Joo; Cheon, Gab-Jin; Byung-Seok, Kim; Seo, Yeon-Seok; Kim, Hyung-Su; Sinn, Dong-Hyun; Chung, Woojin; Kim, Hwi-Young; Lee, Han Ah; Nam, Seung-Woo; Kim, Inhee; Suh, Jung-Il; Kim, Ji H.; Chae, Hee Jeong; Sohn, Jung Ho; Cho, Ju‐Yeon; Kim, Yoon Jun; Yang, Jung–Min; Park, Jung Gil; Kim, Won; Cho, Hyun-Chin; Kim, Dong Joon

doi:10.3390/jcm11092463

Cited by 6 publications

(5 citation statements)

References 33 publications

(43 reference statements)

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“…WBC count is an inflammatory biomarker, and systemic inflammation is related to the development of one or more organ failures in AD patients. 19 , 20 Albumin was confirmed as a biomarker of malnutrition–inflammation syndrome, and decreased albumin had a negative impact on the prognosis of AD patients. 21 , 22 ALT (alanine aminotransferase) is a significant enzyme in the liver, and a previous study confirmed that elevated ALT levels were associated with an increased risk of hepatic complications, which may influence the prognosis of cirrhosis patients.…”

Section: Discussionmentioning

confidence: 99%

Derivation and Validation of a Prognostic Model for Acute Decompensated Cirrhosis Patients

Zhang¹,

Chen²,

Zhang³

et al. 2023

PPA

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Background Acute decompensated cirrhosis (AD) is related to high medical costs and high mortality. We recently proposed a new score model to predict the outcome of AD patients and compared it with the common score model (CTP, MELD and CLIF-C AD score) in the training and validation sets. Materials and Methods A total of 703 patients with AD were enrolled from The First Affiliated Hospital of Nanchang University between December 2018 and May 2021. These patients were randomly assigned to the training set (n=528) and validation set (n=175). Risk factors affecting prognosis were identified by Cox regression analysis and then used to establish a new score model. The prognostic value was determined by the area under the receiver operating characteristic curve (AUROC). Results A total of 192 (36.3%) patients in the training cohort and 51 (29.1%) patients in the validation cohort died over the course of 6 months. A new score model was developed with predictors including age, bilirubin, INR, WBC, albumin, ALT and BUN. The new prognostic score (0.022×Age + 0.003×TBil + 0.397×INR + 0.023×WBC- 0.07×albumin + 0.001×ALT + 0.038×BUN) for long-term mortality was superior to three other scores based on both training and internal validation studies. Conclusion This new score model appears to be a valid tool for assessing the long-term survival of AD patients, improving the prognostic value compared with the CTP, MELD and CLIF-C AD scores.

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Section: Discussionmentioning

confidence: 99%

Derivation and Validation of a Prognostic Model for Acute Decompensated Cirrhosis Patients

Zhang¹,

Chen²,

Zhang³

et al. 2023

PPA

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“…However, there is a need for simple, inexpensive and rapid tests for the prognostic biomarkers presenting in patients with PLA. The PWR is a biomarker that satisfies all these requirements, and its usefulness as a biomarker has been identified in several recent studies [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. We documented the efficacy of PWR as a biomarker in patients with PLA for the first time.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the platelet-to-white blood cell (WBC) ratio (PWR) is increasing in importance in diverse medical settings. As an economic yet powerful hematologic biomarker, PWR has been shown to be correlated with the prognosis of patients with conditions such as acute ischemic stroke [ 19 ], advanced ovarian cancer [ 20 ], liver failure [ 21 ], hepatitis B virus-associated liver cirrhosis [ 22 ], cirrhosis with acute decompensation [ 23 ], intrahepatic cholangiocarcinoma [ 24 ], and even trauma [ 25 ] and metabolic syndrome [ 26 ] based on the WBC counts measured in some studies. Among the studies, PWR has been shown to be correlated with the severity of systemic inflammation.…”

Section: Introductionmentioning

confidence: 99%

Platelet-to-White Blood Cell Ratio: A Feasible Biomarker for Pyogenic Liver Abscess

Park

Kim

et al. 2022

Diagnostics

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The platelet-to-white blood cell ratio (PWR) has been reported to predict the severity of patients with various diseases. However, no previous studies have assessed the use of the PWR as a prognostic marker for pyogenic liver abscesses (PLA). This observational retrospective study was performed between January 2008 and December 2017, including 833 patients with PLA from multiple centers. The enrolled patients, on average, had a PWR of 17.05, and 416 patients had a PWR lower than 17.05. A total of 260 patients (31.2%) with PLA showed complications of metastatic infection, pleural effusion and abscess rupture. A low PWR level was identified as a strong risk factor for metastatic infection and pleural effusion. The low PWR group also had a longer hospital stay. In the multivariate analysis, old age, anemia, albumin and CRP levels and unidentified pathogens were significant factors for low PWR levels. A low PWR, old age, male sex, abscess size, albumin, ALP and unidentified causative pathogens showed significant associations with a hospital stay longer than 28 days. As a result, PLA patients presenting with a low PWR were shown to have more complications and a poor prognosis. Considering its cost-effectiveness, PWR could be a novel biomarker used to predict a prognosis of PLA.

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“…12 Study from Kim et al also concluded that PWR level was more useful prognostic biomarker compared to MELD score. 21,22 Chronic liver failure-sequential organ failure assessment (CLIF-SOFA) established by CANONIC study, is useful for diagnosing ACLF according to the number and type of organ failure. CLIF-SOFA is performed better than other predictive marker in predicting short term mortality for acutely decompensated cirrhosis.…”

Section: Comparison Of Pwr To Others Predictive Marker (Clif Sofa Meld)mentioning

confidence: 99%

Platelet to White Blood Cell Ratio (PWR) to Predict Mortality in Acute on Chronic Liver Failure of Cirrhosis Patient: A Systematic Review

Pandapotan¹,

Gunawan²

2022

InaJGHE

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Background: Liver cirrhosis (LC) is still being important public health concern, due to the rising of global incidence and mortality. There is risk progression in LC patients to acute-on-chronic liver failure (ACLF) patients with high incidence of complication and high short-term mortality rate. It needs rapid and simpler predictor to immediate and accurate triage of the patient. The aim of this study is to review systematically the role of PWR to predict the mortality in ACLF cirrhosis patient.Method: This systematic review study was identified by searching Pub-Med, Cochrane library, and EMBASE database (2016-2022). Only observational studies were included. ACLF patient was selected as the main subject in each study, and PWR was added as short-term mortality predictor. The Cochran seven step model was used to perform the review.Results: Six cohort retrospective studies met inclusion criteria, including total 1,348 patient ACLF. Half of studies included had high level of evidence. The non-survivor ACLF patient had significantly lower PWR values than survivor. The range of HR of PWR to predict mortality in ACLF was 0.665-0.995, with p value 0.0001. Whereas the cutoff range of PWR value to predict non survivor in ACLF patient was 7.83-14.2.Conclusion: PWR had a predictive efficacy, similar to CLIF-SOFA and MELD score in terms of predicting short-term mortality in ACLF patients. PWR showed significantly independent risk factor of short term mortality in ACLF cirrhotic patient.

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Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration

Cited by 6 publications

References 33 publications

Derivation and Validation of a Prognostic Model for Acute Decompensated Cirrhosis Patients

Derivation and Validation of a Prognostic Model for Acute Decompensated Cirrhosis Patients

Platelet-to-White Blood Cell Ratio: A Feasible Biomarker for Pyogenic Liver Abscess

Platelet to White Blood Cell Ratio (PWR) to Predict Mortality in Acute on Chronic Liver Failure of Cirrhosis Patient: A Systematic Review

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