Objective  To explore the short-term prognosis value of combined detection of neutrophil count to lymphocyte count ratio (NLR), prothrombin international standardized ratio to albumin ratio (PTAR), and end-stage liver disease model (MELD) score in patients with decompensated hepatitis B cirrhosis.

Methods  The clinical data of 153 patients with decompensated hepatitis B cirrhosis admitted to Nantong Third Affiliated Hospital of Nantong University from January 2018 to June 2021 were retrospectively analyzed, including 113 in the modeling group and 40 in the validation group. The NLR, PTAR and MELD score were calculated according to the first laboratory hematology indexes before treatment. The end point was the end of 6 months after the start of treatment. The patients in the modeling group were divided into improvement group and progress group according to their survival status at the end of 6 months. The levels of clinical parameters between the improvement and progress groups were compared. Spearman correlation analysis was used to evaluate the correlation among NLR, PTAR and MELD score. Univariate and multivariate regression analyses were carried out on related variables to identify the factors influencing short-term prognosis of patients with decompensated hepatitis B cirrhosis. The ROC curve was used to evaluate the effectiveness of each single index and combined prediction model in predicting the short-term prognosis of patients with decompensated hepatitis B cirrhosis. The validation group data was substituted into the combined prediction model for efficiency validation.

Results  In the modeling group, NLR, PTAR and MELD score in the progress patients were significantly higher than those in the improved patients (P < 0.05). Correlation analysis showed that NLR and PTAR were positively related to MELD score (r values were 0.444 and 0.438, respectively, P < 0.001), and NLR and PTAR were also positively correlated (r＝0.435, P < 0.001). Logistic multivariate analysis showed that AST, Alb, NLR, PTAR and MELD score increasing were independent risk factors for short-term prognosis of patients with decompensated hepatitis B cirrhosis (P < 0.05). The cut-off values of NLR, PTAR and MELD score were 5.045, 49.405 and 15.295, respectively, and the AUC predicting the progression of hepatitis B cirrhosis was 0.738, 0.796 and 0.749, respectively, the prediction efficiency of the combined prediction model was best, and the AUC was 0.832. The combined prediction model also had good prediction efficiency in the validation group, with 0.803 of AUC.

Conclusion  NLR, PTAR and MELD score can be used as independent predictors of short-term prognosis of patients with decompensated hepatitis B cirrhosis and has good predictive value. The predictive value of combined model of the three is more reliable.