title: Lymphocyte-monocyte ratio at admission predicts possible outcomes in patients with acute-on-chronic liver failure.
abstract: 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).
  
  
  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).
  
  
  CONCLUSIONS
  A low LMR measured at admission is predictive of a poor prognosis in AoCLF patients.
authors: aDepartment of Ultrasonography bDepartment of Clinical Laboratory, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang cDepartment of Clinical Laboratory, the Sixth Affiliated Hospital of Xinjiang Medical University, Xinjiang dDepartment of Clinical Laboratory, the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
authors: ShaoMing
authors: S
authors: Zhu
authors: Yulituzi
authors: Y
authors: Waili
authors: XiaoTing
authors: X
authors: Qi
authors: YueMei
authors: Y
authors: Chen
authors: YuFeng
authors: Y
authors: Lou
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D015999:Multivariate Analysis; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors