Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease

Abstract

Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease Introduction: The prognostic significance of neutrophil-to-lymphocyte ratio (NLR), derived-neutrophil-to-lymphocyte ratio (d-NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been shown in many diseases. To the best of our knowledge, there is no published report evaluation of those parameters in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The aims of this study are to evaluate the parameters in predicting in-hospital mortality in patients with AECOPD. Materials and Methods: This is a retrospective study in two referral hospitals in Tabriz and Urmia, Iran. NLRs, PLR, LMR, and d-NLR were calculated from the admission day complete blood count of patients with AECOPD. Comparison was made between patients who died in hospital and those discharged alive. Results: Of 315 patients, 70 (22.2%) died in the hospital and 245 (77.8%) were discharged alive. The mortality rate was higher in patients with NLR ≥ 4 than with NLR < 4 (24% vs. 9.5% p value < 0.001). Multivariate analysis revealed NLR (p= 0.001) were independently associated with in-hospital mortality. NLR had the highest odds ratio for death both in univariate (OR= 3.80) and multivariate (OR= 3.50) analyses. The area under the receiver-operating characteristic curve for NLR in predicting in-hospital death was 0.72 (95% CI: 0.62-0.81; p< 0.001). PLR and LMR did not show significant relation to in-hospital death in AECOPD. Conclusion: This study shows for the first time that higher NLR is positively associated with in-hospital mortality in AECOPD.

The neutrophil‐to‐lymphocyte ratio as a marker of chronic obstructive pulmonary disease and its exacerbations: A systematic review and meta‐analysis

“…Of these, 206 were excluded after initial screening. After full‐text review of the remaining 21 articles, twelve studies were excluded because they did not meet the inclusion criteria . Nine studies were included in the final analysis …”

Correlatıon of neutrophyle/lymphocyte ratio and pulmonary parameters with optic coherence tomography findings in stable chronic obstructive pulmonary disease

“…In previous years, five studies reported that NLR also represents an independent predictor of mortality in COPD patients . Two observational prospective studies found that NLR is an independent predictor of COPD exacerbation during the first‐year follow‐up, although only one of them reported statistically significant differences .…”

“…Additionally, we observed that an increase in NLR during stable phase of COPD was correlated to lower values of inferior RNFL and In previous years, five studies reported that NLR also represents an independent predictor of mortality in COPD patients. [31][32][33][34][35] Two observational prospective studies found that NLR is an independent predictor of COPD exacerbation during the first-year follow-up, although only one of them reported statistically significant differences. 36,37 Some authors also found a moderate correlation between NLR and some functional parameters like FEV 1 and mMRC of COPD cases.…”

Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives

“…The platelet/MPV ratio was not different between the two groups. Survival negatively influenced by elevated CRP in the non-eosinophilic group RAHIMIRAD [51] dNLR, MLR, PLR dNLR higher in dead patients than in those discharged alive. MLR and PLR not significant in multivariate analysis YAO [52] CRP, PLR NLR levels correlated with serum CRP levels in AECOPD.…”

“…RAHIMIRAD et al [51] retrospectively reviewed 315 hospital charts of COPD patients in two Iranian hospitals. NLR values were higher in patients who died in hospital than in those discharged alive.…”