Predictive value of AARC-ACLF score combined with NLR in the short-term prognosis of chronic hepatitis B-related acute liver failure

Abstract

Abstract: Objective To investigate the predictive value of the ACLF Research Group (AARC-ACLF) score combined with the neutrophil-to-lymphocyte ratio (NLR) in assessing the short-term prognosis of hepatitis B (HBV)-related chronic acute liver failure (ACLF). Methods A total of 94 patients diagnosed with HBV-related ACLF were included in this study. Upon admission, the NLR was assessed, and the AARC-ACLF score was calculated within 24 hours. Based on clinical efficacy and survival outcomes, patients were divided into a favorable prognosis group and an unfavorable prognosis group for further analysis of factors influencing disease progression in HBV-related ACLF. The predictive capacity of the AARC-ACLF score and serum NLR level on the prognosis of HBV-related ACLF was assessed. Results Among the 94 participants, 58 showed a favorable prognosis, while 36 exhibited an unfavorable prognosis. In the unfavorable prognosis group, the prothrombin time (PT), total bilirubin (TBIL), white blood cell count (WBC), NLR, and AARC-ACLF score were significantly higher [(26.68±6.91) s, (330.2±126.4) μmol/L, (6.67±2.06) ×10⁹/L, (6.45±2.76), and (10.14±1.29) points, respectively] compared to those in the favorable prognosis group [(20.32±4.20) s, (180.1±83.7) μmol/L, (5.06±1.97) ×10⁹/L, (2.85±1.67), and (8.03±1.09) points; P<0.05]. Elevated NLR and AARC-ACLF scores were identified as significant indicators of poor prognosis among HBV-related ACLF patients (P<0.05). The AUC values for predicting prognosis using serum NLR level, AARC-ACLF score, and the combination of NLR with AARC-ACLF score in HBV-related ACLF patients were 0.878, 0.892, and 0.943, respectively. Conclusion Higher serum NLR levels and AARC-ACLF scores in HBV-related ACLF patients suggest their potential as valuable clinical predictors for short-term prognosis. Combining both factors can enhance the predictive power significantly.

Key words: ACLF research group score of the Asia-Pacific association for liver research, Neutrophil to lymphocyte ratio, Chronic hepatitis B-related acute liver failure, Prognosis

HAN Zhao-dan, XU Jun, LI Peng-peng, ZHAO Wei-juan. Predictive value of AARC-ACLF score combined with NLR in the short-term prognosis of chronic hepatitis B-related acute liver failure[J]. Chinese Hepatolgy, 2024, 29(5): 538-541.

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