The neutrophil‐to‐lymphocyte ratio represents a systemic inflammation marker and reflects the relationship with 90‐day mortality in non‐cirrhotic chronic severe hepatitis

Objectives To investigate the relationship between systemic inflammatory response and short‐term mortality in patients with non‐cirrhotic chronic severe hepatitis (CSH) by using several indicators of inflammation including neutrophil‐to‐lymphocyte ratio (NLR), neutrophil (NEU), white blood cell (WBC), platelet‐to lymphocyte ratio (PLR), and monocyte‐to‐lymphocyte ratio (MLR). Methods Data were collected from two prospectively enrolled CATCH‐LIFE noncirrhotic cohorts. Cox regression analysis was used to investigate the association between systemic inflammatory biomarkers and 90‐day liver transplant (LT)‐free mortality. A generalized additive model (GAM) was used to illustrate the quantitative curve relationship between NLR and 90‐day LT‐free mortality. Kaplan–Meier method was used to estimate the 90‐year LT‐free survival. Results The prevalence of CSH was 20.5% (226/1103). The 28‐day and 90‐day LT‐free mortality rates were 17.7% and 26.1%, respectively, for patients with non‐cirrhotic CSH. Patients with no infection accounted for 75.0% of all CSH patients, and NLR was independently associated with 90‐day LT‐free mortality. NLR of 2.9 might be related to disease deterioration in CSH patients without infection. Conclusions NLR may be an independent risk factor for 90‐day LT‐free mortality in patients with non‐cirrhotic chronic liver disease. A NLR of 2.9 as the cut‐off value can be used to predict disease aggravation in CSH patients without infection. Neutrophil‐to‐lymphocyte ratio (NLR) is an indicator of systemic inflammatory response in patients with chronic severe hepatitis (CSH) in high hepatitis B virus endemic areas, and is significantly associated with 90‐day liver transplant (LT)‐free mortality. In CSH patients without infection, a cut‐off value of NLR of 2.9 is related to disease deterioration