Assessment of Accuracy of Blood Neutrophil to Lymphocyte Ratio (NLR) in Diagnosis of Spontaneous Bacterial Peritonitis (SBP) in Cirrhotic Patients

Abstract

Abstract Background This was across-sectional study conducted on 40 Egyptian patients with decompensated cirrhosis and ascites selected from Internal Medicine and Hepatology outpatient clinics and wards at Ain-Shams University Hospitals. Aim of the Work The aim of this study is to compare accuracy of blood neutrophil lymphocyte ratio (NLR) to ascitic fluid neutrophil lymphocyte ratio (NLR) in diagnosis of SBP. Patients and Methods Patients in this study were divided into 2 groups: Group 1 (case):20 cirrhotic patients diagnosed with (SBP) on the basis of clinical manifestations (fever, abdominal tenderness, and pre-hepatic coma) and laboratory diagnostic criteria: ascitic fluid PMNs greater than 250/mm 3 and culture positive. Group 2 (control): 20 cirrhotic patients with ascites and were admitted with no evidence of (SBP) by clinical and laboratory evaluation. Results According to our results, we found that there was no statistically significant difference found between two groups regarding Age, Sex and Child Classification. There was no statistically significant difference found between two groups regarding WBCs, Platelets, ALT, Creat, Albumin, INR, Bilirubin and Adenosine deaminase, and there was statistically significant difference found between two groups regarding AST and Urea, and there was highly statistically significant difference found between two groups regarding HB. Also there was highly statistically significant difference found between two groups regarding MELD score, SERUM PMNLs, Ascitic PMNLs, Serum NLR and Ascitic NLR. Conclusion Spontaneous bacterial peritonitis is a serious complication in patients with liver cirrhosis and is associated with a considerable risk of mortality. The present study could be of clinical utility in predicting SBP, a major cause of mortality in patients with cirrhosis. NLR is considered an easy test that can be used to diagnose SBP.