Lymphocyte-to-white blood cell ratio is associated with outcome in patients with hepatitis B virus-related acute-on-chronic liver failure

Table 1 Baseline characteristics of hepatitis B virus-acute on chronic liver failure patients

	All patients (n = 330)	Survivor patients (n = 195)	Non-survivor patients (n = 135)	P value
Age (yr)	49.68 ± 12.39	47.91 ± 12.12	52.23 ± 12.39	0.002
Male, n (%)	277 (83.9)	162 (83.1)	115 (85.2)	0.068
Costs (dollars)	10133.88 (5886.57-15955.07)	10734.72 (5958.59-16913.77)	9107.89 (5727.32-14945.14)	0.065
Ascites, n (%)				0.016
Mild	158 (47.9)	104 (53.3)	54 (40.0)
Medium	102 (30.9)	59 (30.3)	43 (31.9)
Severe	70 (21.2)	32 (16.4)	38 (28.1)
PLT (109/L)	108.00 (72.75-144.25)	115.00 (82.00-148.00)	89.00 (57.00-138.00)	0.004
PT (s)	22.70 (19.30-29.25)	21.10 (18.90-25.20)	25.40 (21.80-32.80)	< 0.001
INR	2.01 (1.74-2.64)	1.88 (1.69-2.30)	2.4 (1.94-3.07)	< 0.001
Hemoglobin (g/L)	122.00 (102.00-136.00)	123.00 (107.00-137.00)	121.00 (94.00-135.00)	0.166
Bilirubin (μmol/L)	312.91 ± 135.85	299.15 ± 126.15	332.79 ± 146.96	0.027
Albumin (g/L)	31.40 (28.20-34.25)	31.50 (28.20-34.60)	31.10 (28.20-33.30)	0.151
Creatinine (μmol/L)	66.60 (57.08-84.73)	65.60 (57.00-81.00)	68.30 (57.50-91.90)	0.294
BUN (mmol/L)	4.00 (2.80-6.10)	4.00 (2.80-5.50)	4.10 (3.00-7.60)	0.074
Serum Na (mmol/L)	137.00 (133.30-139.10)	137.00 (133.20-139.00)	136.90 (133.30-139.10)	0.882
LWR	0.17 (0.11-0.23)	0.19 (0.12-0.25)	0.13 (0.08-0.20)	< 0.001
CTPs	11.00 (10.00-12.00)	11.00 (10.00-12.00)	12.00 (11.00-13.00)	< 0.001
MELDs	23.17 (20.03-27.27)	21.59 (18.86-25.46)	25.04 (21.78-29.10)	< 0.001
COSSHACLFIIs	7.18 (6.54-8.12)	6.80 (6.30-7.37)	7.95 (7.20-8.70)	< 0.001

PLT: Platelet; PT: Prothrombin time; INR: International normalized ratio; BUN: Blood urea nitrogen; LWR: Lymphocyte-to-white blood cell ratio; CTPs: Child-Turcotte-Pugh score; MELDs: Model for end-stage liver disease score; COSSHACLFIIs: Chinese group on the study of severe Hepatitis B-Acute-on-chronic liver failure II score.

Table 2 Univariate and multivariate Cox regression analyses in hepatitis B virus-acute on chronic liver failure patients (n = 330)

	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Age	1.021 (1.007-1.035)	0.002	1.015 (1.001-1.030)	0.037
Male sex	1.202 (0.747-1.932)	0.448
PLT (109/L)	0.997 (0.994-0.999)	0.046
PT (s)	1.020 (1.011-1.030)	< 0.001	1.028 (1.015-1.042)	< 0.001
INR	1.042 (0.993-1.094)	0.093
Hemoglobin (g/L)	0.993 (0.987-0.999)	0.027
Bilirubin (μmol/L)	1.001 (1.000-1.003)	0.025	1.001 (1.000-1.003)	0.041
Albumin (g/L)	0.968 (0.933-1.005)	0.091
Creatinine (μmol/L)	1.001 (1.000-1.001)	0.179
BUN (mmol/L)	1.036 (1.014-1.058)	0.001
Serum Na (mmol/L)	1.001 (0.999-1.003)	0.249
LWR	0.011 (0.001-0.088)	< 0.001	0.052 (0.005-0.535)	0.013

In univariate analysis, P < 0.1 were subjected to multivariate analysis and was indicated in bold; in multivariate analysis, P < 0.05 was considered significant and was indicated in bold. CI: Confidence interval; HR: Hazard ratio; PLT: Platelet; PT: Prothrombin time; INR: International normalized ratio; BUN: Blood urea nitrogen; LWR: Lymphocyte-to-white blood cell ratio.

Table 3 Clinical characteristics between low and high lymphocyte-to-white blood cell ratio groups in hepatitis B virus-acute on chronic liver failure patients

	Low LWR level (n = 77)	High LWR level (n = 253)	P value
Age (yr)	52.99 ± 12.57	48.67 ± 12.19	0.007
Male, n (%)	59 (76.6)	218 (86.2)	0.046
Costs (dollars)	7625.18 (3899.37-12070.55)	10984.59 (6639.92-16693.10)	< 0.001
Ascites, n (%)			0.007
Mild	25 (32.5)	133 (52.6)
Medium	29 (37.7)	73 (28.9)
Severe	23 (29.9)	47 (18.6)
PLT (109/L)	86.00 (55.50-138.50)	110.00 (79.50-145.50)	0.039
PT (s)	23.20 (19.70-33.50)	22.40 (19.20-28.00)	0.016
INR	2.13 (1.76-3.11)	1.99 (1.73-2.54)	0.018
Hemoglobin (g/L)	109.00 (89.50-125.50)	125.00 (108.00-139.00)	< 0.001
Bilirubin (μmol/L)	331.52 ± 153.46	307.25 ± 129.82	0.170
Albumin (g/L)	30.10 (26.30-32.50)	31.80 (28.85-34.55)	< 0.001
Creatinine (μmol/L)	82.40 (58.40-126.10)	64.80 (56.85-77.95)	< 0.001
BUN (mmol/L)	7.00 (4.00-11.10)	3.70 (2.70-5.20)	< 0.001
Serum Na (mmol/L)	135.30 (131.50-139.05)	137.20 (133.90-139.10)	0.086
CTPs	12.00 (11.00-13.00)	11.00 (10.00-12.00)	< 0.001
MELDs	25.79 (22.52-30.91)	22.44 (19.55-26.13)	< 0.001
COSSHACLFIIs	8.11 (7.26-9.06)	6.94 (6.40-7.79)	< 0.001
28-d mortality, n (%)	46 (59.7)	89 (35.2)	< 0.001

PLT: Platelet; PT: Prothrombin time; INR: International normalized ratio; BUN: Blood urea nitrogen; LWR: Lymphocyte-to-white blood cell ratio; CTPs: Child-Turcotte-Pugh score; MELDs: Model for end-stage liver disease score; COSSHACLFIIs: Chinese group on the study of severe Hepatitis B-Acute-on-chronic liver failure II score.