Abstract: Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio (NLR) on the progression and clinical outcome of acute-on-chronic liver failure (ACLF).Methods The clinical data of 174 cases of ACLF from 2013 to 2017 in the Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. According to clinical outcome, patients were divided into the survival group and the death group. NLR was compared between the 2 groups. Continuous data were analyzed using univariate analysis and t-test, and categorical data were analyzed using ?2-test. Univariate and multivariate logistic regression analyses were applied to investigate the factors related to disease progression.Results NLR of the survival group (2.45±1.16) was significantly lower than that of the death group (5.55±3.60), which increased gradually with increased mortality. NLR and prothrombin time were the main affecting factors for disease progression (P<0.001). There was a significant difference in baseline NLRs between the survival group and death group (2.45±1.16 vs. 5.55±3.60, P<0.001).Conclusion Peripheral blood NLR can predict early death risk in patients with ACLF.

Key words: Hepatitis B, Acute-on-chronic liver failure, Neutrophil-to-lymphocyte ratio