{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:22:40Z","timestamp":1793125360579,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hallym University Research Fund","award":["HURF-2018\u201303"],"award-info":[{"award-number":["HURF-2018\u201303"]}]},{"name":"Hallym University Research Fund","award":["2020R1A6A1A03043026"],"award-info":[{"award-number":["2020R1A6A1A03043026"]}]},{"name":"Basic Science Research Program","award":["HURF-2018\u201303"],"award-info":[{"award-number":["HURF-2018\u201303"]}]},{"name":"Basic Science Research Program","award":["2020R1A6A1A03043026"],"award-info":[{"award-number":["2020R1A6A1A03043026"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 \u00b1 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9\u201315.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR \u2264 12.1 than for those with a PWR &gt; 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD.<\/jats:p>","DOI":"10.3390\/jcm11092463","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T22:20:20Z","timestamp":1651098020000},"page":"2463","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Platelet-to-White Blood Cell Ratio Is Associated with Adverse Outcomes in Cirrhotic Patients with Acute Deterioration"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5435-6166","authenticated-orcid":false,"given":"Jung Hee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea"},{"name":"Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6236-780X","authenticated-orcid":false,"given":"Sung-Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea"},{"name":"Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do-Seon","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee-Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7747-4293","authenticated-orcid":false,"given":"Tae-Hyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6566-1382","authenticated-orcid":false,"given":"Young-Kul","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9206-9245","authenticated-orcid":false,"given":"Ki Tae","family":"Suk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea"},{"name":"Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baek-Gyu","family":"Jun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Joon","family":"Yim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Hyun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Hee","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul 01757, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon-Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soung-Won","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Young","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-0381","authenticated-orcid":false,"given":"Jeong-Ju","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-777X","authenticated-orcid":false,"given":"Sang-Gyune","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Joo","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22212, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gab-Jin","family":"Cheon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4318-4570","authenticated-orcid":false,"given":"Byung-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu 42472, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Seok","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea"},{"name":"Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Hyun","family":"Sinn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06531, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo-Jin","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwi Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0430-1607","authenticated-orcid":false,"given":"Han Ah","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Woo","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Medical Center, Seoul 04564, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju 54896, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Il","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dongguk University College of Medicine, Kyongju 38067, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3924-0434","authenticated-orcid":false,"given":"Ji-Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee-Bok","family":"Chae","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju 28644, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo-Hyun","family":"Sohn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Yeon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9141-7773","authenticated-orcid":false,"given":"Yoon-Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Mo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Gil","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Chin","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Hospital, Jinju 52727, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-1500","authenticated-orcid":false,"given":"Dong Joon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 24252, Korea"},{"name":"Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Association for The Study of the Liver (2018). 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