Neutrophil–Lymphocyte and Neutrophil–Lymphocyte–Albumin Ratio Prognostic Value in Alcohol-Related Liver Disease

Sachin Patil; Nivedita Tayamgol Reddy; Fouzia Almas

doi:10.15850/ijihs.v14n1.4793

Authors

Sachin Patil Senior Resident, Department of General Medicine, Bidar Institute of Medical Sciences, Bidar, Karnataka India.
Nivedita Tayamgol Reddy Senior Resident, Department of General Medicine, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India.
Fouzia Almas Senior Resident, Department of General Medicine, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India.

DOI:

https://doi.org/10.15850/ijihs.v14n1.4793

Keywords:

Alcoholic Liver Disease, Cirrhosis, Mortality, Neutrophil to lymphocyte ration, Serum Albumin.

Abstract

Background: Alcohol-related liver disease (ALD) is a leading cause of preventable morbidity and mortality. The neutrophil-to-lymphocyte ratio (NLR) and neutrophil–lymphocyte-to-albumin (NLA) ratio are inexpensive, readily available biomarkers reflecting inflammatory and synthetic status.

Objective: To evaluate the prognostic utility of neutrophil-to-lymphocyte ratio (NLR) and neutrophil–lymphocyte-to-albumin (NLA) ratio in predicting 30-day and 90-day mortality in ALD.

Methods: This prospective observational study was conducted over 18 months (June 2024–November 2025) at a tertiary care teaching hospital in South India. Seventy consecutive male patients aged >18 years with alcohol-related liver disease were enrolled. NLR was calculated as the ratio of absolute neutrophil count to absolute lymphocyte count, and NLA as NLR divided by serum albumin. Patients were followed up for 90 days after discharge with mortality assessed at admission, 30 days, and at 90 days.

Results: In-hospital mortality was found to be 71.4%, with cumulative mortality of 20.0% at 30 days and 31.2% at 90 days among patients discharged from the hospital. NLR and NLA demonstrated high predictive performance at all time. At admission, NLR ≥8.6 (AUC 0.92) and NLA ≥32.5 (AUC 0.89) were found to be significantly associated with mortality (p≤0.001). Both markers maintained high sensitivity and specificity at 30 and 90 days.

Conclusion: NLR and NLA are simple, cost-effective prognostic markers that can reliably predict short-term mortality in alcohol-related liver disease. Their integration into routine clinical assessment will enhance early risk stratification and guide timely management decisions in cases of alcoholic liver disease.