Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis
Background. The goal of this systematic review and meta-analysis was analyzing published studies on the role of neutrophil to lymphocyte ratio (NLR) in infection and spatially spontaneous bacterial peritonitis (SBP) among cirrhotic patients. Methods. PubMed, Web of Science, and Scopus were searched...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2022/8604060 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849467617923825664 |
|---|---|
| author | Seyed Arsalan Seyedi Seyed Ali Nabipoorashrafi Jairo Hernandez Andrew Nguyen Brandon Lucke-Wold Shima Nourigheimasi Shokoufeh Khanzadeh |
| author_facet | Seyed Arsalan Seyedi Seyed Ali Nabipoorashrafi Jairo Hernandez Andrew Nguyen Brandon Lucke-Wold Shima Nourigheimasi Shokoufeh Khanzadeh |
| author_sort | Seyed Arsalan Seyedi |
| collection | DOAJ |
| description | Background. The goal of this systematic review and meta-analysis was analyzing published studies on the role of neutrophil to lymphocyte ratio (NLR) in infection and spatially spontaneous bacterial peritonitis (SBP) among cirrhotic patients. Methods. PubMed, Web of Science, and Scopus were searched until May 24, 2022. The Newcastle–Ottawa scale was used for quality assessment. Results. Of 14 studies included in our study, six studies were on infection with 2786 hospitalized cirrhotic patients, of whom 934 developed an infection. Other studies were on SBP with 1573 cirrhotic patients with ascites, of whom 557 developed SBP. The pooled results showed that there was no difference in NLR levels between hospitalized cirrhotic patients who developed infection compared to those who did not (random-effects model: SMD = 0.63, 95% CI = −0.01–1.27, p=0.054). However, cirrhotic patients with ascites who developed SBP had elevated levels of NLR compared to those who did not (random-effects model: SMD = 1.05, 95% CI = 0.52–1.57,p<0.001). This difference remained significant in prospective studies (SMD = 0.94, 95% CI = 0.51–1.38,p<0.001) but not in retrospective studies (SMD = 1.37, 95% CI = −0.56–3.29,p=0.165), in the subgroup analysis according to the study design. The pooled sensitivity of NLR was 92.07% (95% CI = 74.85%–97.84%) and the pooled specificity was 72.58% (95% CI = 57.72%–83.69%). The pooled positive likelihood ratio, negative likelihood ratio, DOR of NLR were 3.35(95%CI = 2.06–5.46), 0.10 (95%CI = 0.03–0.38), and 30.78 (95%CI = 7.01–135.04), respectively. Conclusion. Our results support NLR to be a valid biomarker that can be readily integrated into clinical settings to help in the prevention and prediction of SBP among cirrhotic patients. |
| format | Article |
| id | doaj-art-e0738aa79e44403f8c58b3e9b42e0c96 |
| institution | Kabale University |
| issn | 2291-2797 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-e0738aa79e44403f8c58b3e9b42e0c962025-08-20T03:26:09ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27972022-01-01202210.1155/2022/8604060Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysisSeyed Arsalan Seyedi0Seyed Ali Nabipoorashrafi1Jairo Hernandez2Andrew Nguyen3Brandon Lucke-Wold4Shima Nourigheimasi5Shokoufeh Khanzadeh6Endocrinology and Metabolism Research Center (EMRC)Endocrinology and Metabolism Research Center (EMRC)Department of NeurosurgeryDepartment of NeurosurgeryDepartment of NeurosurgerySchool of MedicineStudent Research CommitteeBackground. The goal of this systematic review and meta-analysis was analyzing published studies on the role of neutrophil to lymphocyte ratio (NLR) in infection and spatially spontaneous bacterial peritonitis (SBP) among cirrhotic patients. Methods. PubMed, Web of Science, and Scopus were searched until May 24, 2022. The Newcastle–Ottawa scale was used for quality assessment. Results. Of 14 studies included in our study, six studies were on infection with 2786 hospitalized cirrhotic patients, of whom 934 developed an infection. Other studies were on SBP with 1573 cirrhotic patients with ascites, of whom 557 developed SBP. The pooled results showed that there was no difference in NLR levels between hospitalized cirrhotic patients who developed infection compared to those who did not (random-effects model: SMD = 0.63, 95% CI = −0.01–1.27, p=0.054). However, cirrhotic patients with ascites who developed SBP had elevated levels of NLR compared to those who did not (random-effects model: SMD = 1.05, 95% CI = 0.52–1.57,p<0.001). This difference remained significant in prospective studies (SMD = 0.94, 95% CI = 0.51–1.38,p<0.001) but not in retrospective studies (SMD = 1.37, 95% CI = −0.56–3.29,p=0.165), in the subgroup analysis according to the study design. The pooled sensitivity of NLR was 92.07% (95% CI = 74.85%–97.84%) and the pooled specificity was 72.58% (95% CI = 57.72%–83.69%). The pooled positive likelihood ratio, negative likelihood ratio, DOR of NLR were 3.35(95%CI = 2.06–5.46), 0.10 (95%CI = 0.03–0.38), and 30.78 (95%CI = 7.01–135.04), respectively. Conclusion. Our results support NLR to be a valid biomarker that can be readily integrated into clinical settings to help in the prevention and prediction of SBP among cirrhotic patients.http://dx.doi.org/10.1155/2022/8604060 |
| spellingShingle | Seyed Arsalan Seyedi Seyed Ali Nabipoorashrafi Jairo Hernandez Andrew Nguyen Brandon Lucke-Wold Shima Nourigheimasi Shokoufeh Khanzadeh Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis Canadian Journal of Gastroenterology and Hepatology |
| title | Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis |
| title_full | Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis |
| title_fullStr | Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis |
| title_short | Neutrophil to Lymphocyte Ratio and Spontaneous Bacterial Peritonitis among Cirrhotic Patients: A Systematic Review and Meta-analysis |
| title_sort | neutrophil to lymphocyte ratio and spontaneous bacterial peritonitis among cirrhotic patients a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2022/8604060 |
| work_keys_str_mv | AT seyedarsalanseyedi neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis AT seyedalinabipoorashrafi neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis AT jairohernandez neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis AT andrewnguyen neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis AT brandonluckewold neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis AT shimanourigheimasi neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis AT shokoufehkhanzadeh neutrophiltolymphocyteratioandspontaneousbacterialperitonitisamongcirrhoticpatientsasystematicreviewandmetaanalysis |