The Role of NLR (Neutrophil-To-Lymphocyte Ratio) in Predicting Survival in CLD (Chronic Liver Disease) a Correlation with CTP, UKELD and MELD Na Score

Introduction: Chronic Liver Disease (CLD) is a global health issue with increasing mortality. Neutrophil-to-Lymphocyte Ratio (NLR), a simple marker derived from routine blood tests, has emerged as a potential predictor of disease severity in Chronic Liver Disease. This study investigates the role of NLR in assessing disease severity and predicting clinical outcomes in CLD patient. Method: This one-year observational study at SRMS IMS, Bareilly, included 140 adult CLD patients admitted to the inpatient department, with chronic liver disease confirmed by ultrasound. Patients with secondary immunodeficiencies, hepatocellular carcinoma, or acute liver failure were excluded. Demographic, clinical, and laboratory data, including NLR from blood counts, were collected. Follow-up assessments monitored patient outcomes. Data analysis was performed using SPSS and MS Excel, with ethical approval from the institutional committee. Result: The mean NLR in the study was 3.53 ± 1.22. A significant difference in NLR was found across CTP classes: Class A (2.14 ± 0.78), Class B (3.45 ± 1.18), and Class C (4.14 ± 1.16) with a p-value of 0.01*. NLR showed positive correlations with albumin (r = 0.171, p = 0.044), bilirubin (r = 0.363, p = 0.001), and CTP score (r = 0.386, p < 0.001). Significant differences in albumin (p = 0.015*), prothrombin time (p = 0.021*), and bilirubin (p = 0.001*) were observed across NLR groups. Conclusion: NLR is a reliable and cost-effective marker for assessing the severity and prognosis of CLD. Its association with liver function parameters and CTP score suggests its potential utility in risk stratification and management of CLD patients. Further studies with larger cohorts are recommended to validate its prognostic value.