What Markers of Inflammation can be used as Predictors of Mortality

What Markers of Inflammation can be used as Predictors of Mortality

Cirrhosis is a chronic liver disease characterized by the replacement of healthy liver tissue with scar tissue, leading to impaired liver function. It is a serious condition that can have life-threatening complications, including liver failure and death. Identifying markers that can predict mortality in cirrhosis patients is crucial for timely intervention and improved patient outcomes.

The Role of Inflammation in Cirrhosis

Inflammation plays a significant role in the progression and complications of cirrhosis. Chronic liver injury triggers an inflammatory response, leading to the activation of immune cells and the release of various inflammatory markers. These markers can serve as indicators of disease severity and prognosis.

Markers of Inflammation as Predictors of Mortality

Several studies have investigated the association between markers of inflammation and mortality in cirrhosis patients. One commonly studied marker is C-reactive protein (CRP), an acute-phase reactant produced by the liver in response to inflammation. Elevated levels of CRP have been found to be associated with increased mortality in cirrhosis patients.

Another marker of inflammation that has shown promise in predicting mortality is the neutrophil-to-lymphocyte ratio (NLR). NLR is calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. High NLR values have been associated with increased mortality in cirrhosis patients, indicating a more severe inflammatory response.

Other Inflammatory Markers

In addition to CRP and NLR, other markers of inflammation have also been studied in relation to mortality in cirrhosis. These include interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and procalcitonin. Elevated levels of these markers have been associated with poor prognosis and increased mortality in cirrhosis patients.

Implications for Clinical Practice

The identification of markers of inflammation that can predict mortality in cirrhosis patients has important implications for clinical practice. These markers can help clinicians assess disease severity, guide treatment decisions, and identify patients who may benefit from early intervention or closer monitoring.

By regularly monitoring inflammatory markers, clinicians can identify patients at higher risk of mortality and implement appropriate interventions to improve outcomes. This may include closer follow-up, aggressive management of complications, or timely referral for liver transplantation.


Markers of inflammation, such as CRP, NLR, IL-6, TNF-alpha, and procalcitonin, can serve as valuable predictors of mortality in cirrhosis patients. Incorporating these markers into routine clinical practice can help identify high-risk patients and guide treatment decisions. Further research is needed to validate these markers and determine their optimal cutoff values for predicting mortality in cirrhosis.