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D’Amico T, Miglionico M, Cangemi R, Romiti GF, De Fabrizio B, Fasano S, Recchia F, Stefanini L, Raparelli V, Violi F, Basili S, P. R. O.-LIVER Collaborators, Palasciano G, D’Alitto F, Palmieri VO, Santovito D, Di Michele D, Croce G, Sacerdoti D, Brocco S, Fasolato S, Cecchetto L, Bombonato G, Bertoni M, Restuccia T, Andreozzi P, Liguori ML, Perticone F, Caroleo B, Perticone M, Staltari O, Manfredini R, De Giorgi A, Averna M, Giammanco A, Granito A, Pettinari I, Marinelli S, Bolondi L, Falsetti L, Salvi A, Durante-Mangoni E, Cesaro F, Farinaro V, Ragone E, Morana I, Andriulli A, Ippolito A, Iacobellis A, Niro G, Merla A, Raimondo G, Maimone S, Cacciola I, Varvara D, Drenaggi D, Staffolani S, Picardi A, Vespasiani-Gentilucci U, Galati G, Gallo P, Davì G, Schiavone C, Santilli F, Tana C, Licata A, Soresi M, Bianchi GB, Carderi I, Pinto A, Tuttolomondo A, Ferrari G, Gresele P, Fierro T, Morelli O, Laffi G, Romanelli RG, Arena U, Stasi C, Gasbarrini A, Gargovich M, Zocco MA, Riccardi L, Ainora ME, Capeci W, Martino GP, Nobili L, Cavallo M, Frugiuele P, Greco A, Pietrangelo A, Ventura P, Cuoghi C, Marcacci M, Serviddio G, Vendemiale G, Villani R, Gargano R, Vidili G, Di Cesare V, et alD’Amico T, Miglionico M, Cangemi R, Romiti GF, De Fabrizio B, Fasano S, Recchia F, Stefanini L, Raparelli V, Violi F, Basili S, P. R. O.-LIVER Collaborators, Palasciano G, D’Alitto F, Palmieri VO, Santovito D, Di Michele D, Croce G, Sacerdoti D, Brocco S, Fasolato S, Cecchetto L, Bombonato G, Bertoni M, Restuccia T, Andreozzi P, Liguori ML, Perticone F, Caroleo B, Perticone M, Staltari O, Manfredini R, De Giorgi A, Averna M, Giammanco A, Granito A, Pettinari I, Marinelli S, Bolondi L, Falsetti L, Salvi A, Durante-Mangoni E, Cesaro F, Farinaro V, Ragone E, Morana I, Andriulli A, Ippolito A, Iacobellis A, Niro G, Merla A, Raimondo G, Maimone S, Cacciola I, Varvara D, Drenaggi D, Staffolani S, Picardi A, Vespasiani-Gentilucci U, Galati G, Gallo P, Davì G, Schiavone C, Santilli F, Tana C, Licata A, Soresi M, Bianchi GB, Carderi I, Pinto A, Tuttolomondo A, Ferrari G, Gresele P, Fierro T, Morelli O, Laffi G, Romanelli RG, Arena U, Stasi C, Gasbarrini A, Gargovich M, Zocco MA, Riccardi L, Ainora ME, Capeci W, Martino GP, Nobili L, Cavallo M, Frugiuele P, Greco A, Pietrangelo A, Ventura P, Cuoghi C, Marcacci M, Serviddio G, Vendemiale G, Villani R, Gargano R, Vidili G, Di Cesare V, Masala M, Delitala G, Invernizzi P, Di Minno G, Tufano A, Purrello F, Privitera G, Forgione A, Curigliano V, Senzolo M, Rodríguez-Castro KI, Giannelli G, Serra C, Neri S, Rizzetto M, Debernardi Venon W, Svegliati Baroni G, Bergamaschi G, Masotti M, Costanzo F, Corazza GR, Caldwell SH, Angelico F, Del Ben M, Napoleone L, Polimeni L, Proietti M, Raparelli V, Romiti GF, Ruscio E, Severoni A, Talerico G, Toriello F, Vestri A, Stefanini L, Rumbolà L, Buoninfante G, Maiorca F, Sabetta A, Di Cola S. Neutrophil–lymphocyte ratio is associated with worse outcomes in patients with cirrhosis: insights from the PRO-LIVER Registry. Intern Emerg Med 2025. [DOI: 10.1007/s11739-025-03955-x] [Show More Authors] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2025] [Accepted: 04/17/2025] [Indexed: 06/02/2025]
Abstract
Abstract
Background
Liver cirrhosis (LC) is a leading global cause of morbidity and mortality, with inflammation playing a key role in disease progression and clinical complications of LC. The Neutrophil/Lymphocyte Ratio (NLR), a readily available marker of systemic inflammation, has been linked to short-term adverse outcomes in LC, but data on long-term follow-up are limited. This study aimed to investigate the relationship between NLR and long-term all-cause mortality in an unselected cohort of LC patients.
Methods
Data were gathered from the Italian multicenter observational study “PRO-LIVER”. Patients with available data to calculate NLR at baseline were included. Baseline clinical determinants of NLR and the association of NRL with all-cause mortality at 2-year follow-up were evaluated.
Results
From the overall cohort (n = 753), 506 patients with LC (31% female, mean age 64.8 ± 11.9 years) were included in the analysis. Median value of NLR was 2.42 (Interquartile Range [IQR]: 1.61–3.52). At baseline, patients with NLR ≥ 2.42 were more likely to have Child–Pugh B or C, hepatocellular carcinoma (HCC), or portal vein thrombosis (PVT). After a median follow-up of 21 months, 129 patients died: 44 (17%) with NLR < 2.42 and 85 (34%) with NLR ≥ 2.42 (p < 0.001). At multiple-adjusted Cox regression analysis, NLR ≥ 2.42 was independently associated with all-cause mortality (HR: 1.65; 95% CI: 1.12–2.44; p = 0.012), along with age, Child–Pugh C class, HCC and PVT.
Conclusions
NLR is associated with long-term all-cause mortality in LC. NLR may serve as a potentially easily available tool to aid risk refinement in LC.
Trial registration number
ClinicalTrials.gov Identifier: NCT01470547.
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Yao N, Wang X, Yang M, Wang X, Dou X. Bayesian Analysis of Length of Stay Determinants in ERAS-Guided Hip Arthroplasty. Healthcare (Basel) 2025; 13:777. [PMID: 40218074 PMCID: PMC11989033 DOI: 10.3390/healthcare13070777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Revised: 03/21/2025] [Accepted: 03/28/2025] [Indexed: 04/14/2025] Open
Abstract
Background and Objectives: Total hip arthroplasty in China expanded rapidly post-2019. The length of hospital stay in these procedures reflects healthcare quality standards. This study analyzed the correlation between preoperative clinical factors and the length of hospital stay in total hip arthroplasty patients managed via an enhanced recovery after surgery protocol. Methods: Preoperative clinical variables were collected from total hip arthroplasty patients in an accelerated rehabilitation program. One-way ANOVA and other statistical methods analyzed correlations between these data and hospitalization time. Results: A total of 408 patients were included, with a mean length of stay of 12.01 ± 4.281 days. Right lower extremity strength (t = 2.794, p = 0.005), activities of daily living score (t = -3.481, p = 0.001), C-reactive protein (t = -2.514, p = 0.016), thrombin time (t = -2.393, p = 0.019), and prothrombin activity (t = 2.582, p = 0.013) can directly affect the length of stay in patients with total hip arthroplasty. Also, age (F = 1.958, p = 0.006) and erythrocyte sedimentation rate (t = -2.519, p = 0.015) were found to affect the length of hospital stay indirectly. Conclusions: This study demonstrated that right lower extremity strength, activities of daily living score, C-reactive protein, thrombin time, and prothrombin activity significantly influence the length of hospital stay in enhanced recovery after surgery-managed total hip arthroplasty patients. Therefore, early interventions should be made to address the above factors.
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Affiliation(s)
- Nan Yao
- School of Nursing, Lanzhou University, Lanzhou 730000, China; (N.Y.)
| | - Xiaoyan Wang
- Department of Nursing, The Second Hospital of Lanzhou University, Lanzhou 730030, China
| | - Meng Yang
- School of Nursing, Lanzhou University, Lanzhou 730000, China; (N.Y.)
| | - Xinglei Wang
- Department of Nursing, The Second Hospital of Lanzhou University, Lanzhou 730030, China
| | - Xinman Dou
- Department of Nursing, The Second Hospital of Lanzhou University, Lanzhou 730030, China
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