Study of Neutrophil-To-Lymphocyte Ratio (NLR) and Its Correlation with Severity of Decompensated Cirrhosis of Liver Based on Child-Turcotte Pugh (CTP) Score

Background: Cirrhosis of the liver is the end stage of chronic liver disease marked by fibrosis, regenerative nodules, and architectural distortion. Disease severity is graded by the Child?Turcotte?Pugh (CTP) score, while the neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a simple biomarker of systemic inflammation and immune imbalance. Since inflammation drives hepatic decompensation, NLR may serve as a prognostic indicator of cirrhosis severity. Objective: To assess the relationship between NLR and the severity of decompensated cirrhosis based on the CTP score. Methods: A cross-sectional study was performed on 65 patients with decompensated cirrhosis admitted to General Hospital, Jayanagar, Bengaluru, from August 2022 to December 2023. NLR was derived from complete blood counts, and CTP scores were calculated using bilirubin, albumin, INR, ascites, and encephalopathy parameters. Correlations were analyzed using Pearson?s coefficient, with p < 0.05 considered significant. Results: The mean age was 44.9 ? 11.5 years; 89.2% were males. Most patients (61.5%) had NLR > 3.53, and CTP classes A, B, and C comprised 9.2%, 43.1%, and 47.7% respectively. NLR correlated positively with CTP score (r = 0.345, p = 0.005), prothrombin time, INR, bilirubin, and encephalopathy, and negatively with hemoglobin and albumin. Conclusion: Elevated NLR reflects greater disease severity in decompensated cirrhosis and may serve as a rapid, inexpensive prognostic marker complementing the CTP score.