Abstract
BACKGROUND: HBV-related acute-on-chronic liver failure (HBV-ACLF) has a high short-term mortality rate, making early prognosis vital. This study investigated the predictive value of the neutrophil percentage-to-albumin ratio (NPAR) in HBV-ACLF. METHODS: This retrospective study analyzed consecutive patients hospitalized with HBV-ACLF to identify risk factors for 90-day mortality. Disease severity was assessed using the Model for End-Stage Liver Disease (MELD) score, and multivariate regression analysis was performed to identify independent risk factors for mortality. RESULTS: A total of 189 patients with HBV-ACLF were included in the analysis. The 90-day mortality rate was 45.5%. Higher NPAR levels were markedly associated with an increased mortality risk and were identified as an independent predictor comparable to the MELD score. The combination of NPAR and MELD score provided better prognostic accuracy than use of either marker alone. CONCLUSIONS: NPAR is a valuable predictor of 90-day mortality in HBV-ACLF patients, and its combination with the MELD score improves prognostic accuracy.