Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Calculated Indices | First Publication | Required Parameters | Formula |
---|---|---|---|
AAR | Williams, Hoofnagle (1988) [14] | AST, ALT | |
Modified APRI | Fix et al. (2005) [15] | albumin, AST, PLT, age | |
FIB-4 | Sterling et al. (2006) [16] | ALT, AST, PLT, age | |
NLR | Zahorec R (2001) [8] | neutrophil, lymphocyte | |
LMR | Merekoulias G et al. (2010) [9] | lymphocyte, monocyte | |
PLR | Turkmen K et al. (2013) [10] | PLT, lymphocyte | |
NMR | Cihan YB et al. (2013) [11] | neutrophil, monocyte | |
CTP | Pugh et al. (1973) [12] | bilirubin, albumin, prothrombin time, ascites, encephalopathy | a |
MELD | Bambha K et al. (2004) [13] | creatinine, bilirubin, INR | b |
Infection Type | Infectious Agent | Number of Cases (% of All Infections) |
---|---|---|
UTI | Escherichia coli Klebsiella pneumoniae Enterococcus faecalis | 32 (53.3%) 16 (26.7%) 4 (6.7%) |
Pneumonia | Mycobacterium tuberculosis Citrobacter freundi Candida albicans | 1 (1.7%) 1 (1.7%) 1 (1.7%) |
Sepsis | Staphylococcus aureus Coagulase-negative staphylococci Escherichia coli Streptococcus group B | 3 (5.0%) 2 (3.3%) 1 (1.7%) 1 (1.7%) |
SBP | Escherichia coli Enterobacter faecalis | 1 (1.7%) 1 (1.7%) |
Infected post-operative wound | Staphylococcus epidermidis | 1 (1.7%) |
Abscess of subcutaneous tissue | Escherichia coli | 2 (3.3%) |
Parameter | Presence of Infection (n = 60) | Lack of Infection (n = 149) | p |
---|---|---|---|
NLR | 2.45 (1.45–6.00) | 1.85 (1.30–3.01) | 0.024 a |
LMR | 1.43 (1.06–2.01) | 2.59 (1.73–3.84) | <0.001 c |
PLR | 91.5 (58.8–118.6) | 73.2 (50.8–99.6) | 0.047 a |
NMR | 5.00 (3.64–7.52) | 4.87 (3.72–7.33) | 0.988 |
Monocytes [G/L] | 0.70 (0.42–1.02) | 0.54 (0.36–0.75) | 0.011 a |
AAR | 1.88 (1.41–2.49) | 1.57 (0.98–2.01) | 0.014 a |
Modified APRI | 15.86 (7.82–30.85) | 12.18 (6.58–31.76) | 0.755 |
FIB-4 | 6.25 (2.99–10.72) | 6.37 (3.30–12.03) | 0.960 |
CRP [mg/L] | 30.7 (9.2–40.6) | 6.5 (2.1–29.6) | 0.020 a |
CTP | 10 (8–11) | 8 (6–9) | <0.001 c |
MELD | 15 (12–22) | 13 (10–17) | 0.006 b |
Parameter | AUC | p | Cut-Off | Se | Sp | PPV | NPV |
---|---|---|---|---|---|---|---|
NLR | 0.606 | 0.033 a | 3.96 | 0.434 | 0.860 | 0.561 | 0.787 |
LMR | 0.715 | <0.001 c | 2.06 | 0.676 | 0.758 | 0.899 | 0.424 |
Monocytes | 0.648 | 0.010 a | 0.91 | 0.455 | 0.867 | 0.517 | 0.835 |
AAR | 0.610 | 0.013 a | 2.11 | 0.417 | 0.797 | 0.472 | 0.759 |
CRP | 0.685 | 0.010 a | 9.2 | 0.760 | 0.600 | 0.613 | 0.750 |
CTP | 0.687 | <0.001 c | 9.0 | 0.702 | 0.639 | 0.485 | 0.816 |
MELD | 0.629 | 0.005 b | 18 | 0.439 | 0.783 | 0.500 | 0.738 |
Univariate | Multivariate | |||||||
---|---|---|---|---|---|---|---|---|
Predictor | Odds Ratio | CI | p | Nagelkerke’s R2 | Odds Ratio | CI | p | Nagelkerke’s R2 |
LMR | 0.15 | 0.06–0.37 | <0.001 c | 0.199 | 0.22 | 0.08–0.64 | 0.005 b | 0.251 |
MONO | 5.42 | 2.23–13.15 | <0.001 c | 0.144 | ||||
NLR | 4.38 | 2.09–9.17 | <0.001 c | 0.116 | ||||
CRP | 3.86 | 1.24–12.04 | 0.020 a | 0.133 | ||||
CTP | 3.17 | 1.52–6.62 | 0.002 b | 0.090 | 2.77 | 1.01–7.60 | 0.048 a | |
MELD | 3.18 | 1.54–6.56 | 0.002 b | 0.077 | ||||
AAR | 2.68 | 1.39–5.18 | 0.003 b | 0.060 |
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Piotrowski, D.; Sączewska-Piotrowska, A.; Jaroszewicz, J.; Boroń-Kaczmarska, A. Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis. Int. J. Environ. Res. Public Health 2020, 17, 1727. https://doi.org/10.3390/ijerph17051727
Piotrowski D, Sączewska-Piotrowska A, Jaroszewicz J, Boroń-Kaczmarska A. Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis. International Journal of Environmental Research and Public Health. 2020; 17(5):1727. https://doi.org/10.3390/ijerph17051727
Chicago/Turabian StylePiotrowski, Damian, Anna Sączewska-Piotrowska, Jerzy Jaroszewicz, and Anna Boroń-Kaczmarska. 2020. "Lymphocyte-To-Monocyte Ratio as the Best Simple Predictor of Bacterial Infection in Patients with Liver Cirrhosis" International Journal of Environmental Research and Public Health 17, no. 5: 1727. https://doi.org/10.3390/ijerph17051727