Original Article

Prognostic Value of Inflammatory Markers in Septic Critically Ill Patients with Chronic Liver Disease: A Retrospective Analysis*

Volume 36 · Issue 9 Publish Date: June 16, 2025
Nazlıhan Boyacı Dündar ORCID Kamil İnci ORCID Gülbin Aygencel ORCID Melda Türkoğlu ORCID Onur Gökçe ORCID Mehmet Cindoruk ORCID
Full Text PDF
DOI

Published In

Turkish Journal of Gastroenterology

Volume 36 · Issue 9

Pages: 600-608

History

Published Online: June 16, 2025

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2025 Nazlıhan Boyacı Dündar, Kamil İnci, Gülbin Aygencel, Melda Türkoğlu, Onur Gökçe, Mehmet Cindoruk

Nazlıhan Boyacı Dündar ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Kamil İnci ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Gülbin Aygencel ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Melda Türkoğlu ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Onur Gökçe ORCID
Yunus Emre State Hospital, Eskişehir, Türkiye
Mehmet Cindoruk ORCID
Department of Gastroenterology and Hepatology, Gazi University School of Medicine, Ankara, Türkiye
Boyacı Dündar, N., İnci, K., Aygencel, G., Türkoğlu, M., Gökçe, O., & Cindoruk, M. (2025). Prognostic Value of Inflammatory Markers in Septic Critically Ill Patients with Chronic Liver Disease: A Retrospective Analysis*. Turkish Journal of Gastroenterology, 36(9), 600–608. https://doi.org/10.5152/tjg.2025.24794
Endnote/Zotero/Mendeley (RIS) BibTeX
Full Text Full Text PDF

Abstract

Background/Aims: Septic patients with chronic liver disease (CLD) experience high morbidity and mortality rates, particularly in the intensive care unit (ICU) setting, due to immune dysfunction. Despite their vulnerability, data on prognostic markers remain scarce, particularly when assessed in conjunction with disease severity scores. This study aimed to evaluate the prognostic value of various inflammatory markers, including white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), lactate, and lactate-to-albumin ratio (LAR), in septic critically ill CLD patients.

Materials and Methods: A retrospective cohort study was conducted on 126 septic CLD patients admitted to ICU. Data on demographics, clinical scores, inflammatory markers, and clinical outcomes were collected. Logistic regression and ROC analyses were used to identify independent predictors of ICU mortality.

Results: Intensive care unit mortality was 66%. In addition to higher Acute Physiology and Chronic Health Evaluation II (APACHE II) (39.3 Å} 7.2 vs. 21 Å} 5.1, P < .001), Sequential Organ Failure Assessment (12.4 Å} 3.5 vs. 8.5 Å} 3.1, P < .001), CLIF-C ACLF [63 (54-69) vs. 50 (41-53)] scores, ICU non-survivors had higher WBC (median: 14 400/μL vs. 7300/μL, P < .001), lactate (median: 4.6mmol/L vs. 2.4mmol/L, P < .001), NLR (median: 12.5 vs. 9, P = .015), and LAR (median: 2.15 vs. 0.93, P < .001) compared to survivors. Multivariate analysis identified APACHE II (OR 1.183, 95% CI: 1.003-1.396, P = .046), CLIF-C ACLF (OR 1.104, 95% CI: 1.002-1.216, P = .046), and LAR (OR 2.992, 95% CI: 1.277-7.009, P = .012) as independent predictors of ICU mortality. The LAR was the most significant inflammatory marker (area under the curve: 0.783, cut-off: 1.17), even in the subgroup of patients with low acute decompensation scores based on the CLIF-C ACLF score.

Conclusion: The LAR was a valuable prognostic marker for ICU mortality in septic CLD patients, even in the absence of advanced organ failure. This marker potentially outperforms other traditional inflammatory markers and could aid in early risk stratification for critically ill septic CLD patients.

 

Cite this article as: Boyacı Dündar N, İnci K, Aygencel G, Türkoğlu M, G.k.e O, Cindoruk M. Prognostic Value of Inflammatory Markers in Septic Critically Ill Patients with Chronic Liver Disease: A Retrospective Analysis. Turk J Gastroenterol. 2025;36(9):600-608.

Most read articles by the same author(s)

1 2 3 > >> 
Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 36 · Issue 9
Pages 600-608
DOI 10.5152/tjg.2025.24794
History
Published Online June 16, 2025
License
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright
Copyright (c) 2025 Nazlıhan Boyacı Dündar, Kamil İnci, Gülbin Aygencel, Melda Türkoğlu, Onur Gökçe, Mehmet Cindoruk
Affiliations
Nazlıhan Boyacı Dündar ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Kamil İnci ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Gülbin Aygencel ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Melda Türkoğlu ORCID
Department of Internal Medicine, Division of Intensive Care Medicine, Gazi University School of Medicine, Ankara, Türkiye
Onur Gökçe ORCID
Yunus Emre State Hospital, Eskişehir, Türkiye
Mehmet Cindoruk ORCID
Department of Gastroenterology and Hepatology, Gazi University School of Medicine, Ankara, Türkiye
Cite this Article
Boyacı Dündar, N., İnci, K., Aygencel, G., Türkoğlu, M., Gökçe, O., & Cindoruk, M. (2025). Prognostic Value of Inflammatory Markers in Septic Critically Ill Patients with Chronic Liver Disease: A Retrospective Analysis*. Turkish Journal of Gastroenterology, 36(9), 600–608. https://doi.org/10.5152/tjg.2025.24794
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX
Outlines