Hepatitis B virus (HBV) infection remains a major cause of liver cirrhosis in China. 1 Every year, approximately 3% of cases of compensated cirrhosis progress to decompensated cirrhosis, which is characterized by various complications and an estimated 5-year mortality rate of up to 85%. 2-4 The identification of accurate, objective, and user-friendly prognostic markers is essential to guide management strategies for patients with HBV-associated decompensated cirrhosis (HBV-DeCi). There is increasing evidence that the hematological parameters, such as neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, red cell distribution width, and mean platelet volume, are reliable inflammatory markers and prognostic indices in a variety of medical conditions like cerebral hemorrhage, 5,6 major cardiac events, 7,8 brain infarct, 9,10 cancers, 11 sepsis, and infectious pathologies. 12 In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management. Their low-cost and consequent wide and easy availability in daily clinical practice have made them very