Relative lymphocyte count as an indicator of 3-year mortality in elderly people with severe COPD

Abstract

BackgroundPrognostic stratification of elderly patients with chronic obstructive pulmonary disease (COPD) is difficult due to the wide inter-individual variability in the course of the disease. No marker can exactly stratify the evolution and natural history of COPD patients. Studies have shown that leukocyte count is associated with increased risk of mortality in COPD patients. The aim of this study was to evaluate the possible role of relative lymphocyte count as a risk marker for mortality in elderly patients with COPD.Methods and resultsThis is a3-year prospective study. A total of 218patients, mean age 75.2±7 years, with moderate to severe COPD and free from conditions affecting lymphocyte count were enrolled. The population was divided into two groups according to the relative lymphocyte count, with a cut-off of 20%. Eighty-five patients (39%) had a relative lymphocyte count ≤20%. Three-year mortality rates from any cause in patients with relative lymphocyte count ≤ or > 20% were 68 and 51%, respectively (p = 0.0012). Survival curve analysis showed higher mortality in patients with relative lymphocyte count ≤20% (p = 0.0005). After adjustment for age and sex, the hazard ratio for mortality risk according to lymphocyte count was 1.79 (95% confidence interval [CI]: 1.26–2.57, p = 0.0013), even in the analysis limited to the 171 patients without congestive heart failure (1.63; 95% CI: 1.03–2.58, p = 0.038).ConclusionsLow relative lymphocyte count was associated with higher mortality in elderly patients with severe COPD.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0685-6) contains supplementary material, which is available to authorized users.

Predictors of Mortality in COPD Exacerbation Cases Presenting to the Respiratory Intensive Care Unit

“…The study showed that relative lymphocyte count ≤ 20% were signi cantly associated with higher risk of death in elderly patients with moderate-to-severe COPD. [15] Xiong et al and Yao et al found that patients with COPD who died had lower lymphocyte count than patients who survived, but lymphocyte count was not an independent risk factor for in-hospital mortality of AECOPD patients. [16,17] We observed that lymphocytopenia occurred in more than 65% of patients in non-survivors group and also an independent risk factor for in-hospital mortality (OR 3.60 (1.10-11.76)).…”

Relationship of Red Cell Index with the Severity of COPD

“…A low relative lymphocyte count is associated with a high mortality rate in elderly patients with severe COPD [21]. A characteristic cellular immune response with important diagnostic signi cance in the airway and lung parenchyma.…”

Comparison of complete blood counts of stable COPD patients at two different altitude in Turkey.

“…Low lymphocyte count is a physiological adaptation mechanism of the immune system to increasing age. 18 Additively, lymphocyte count is expected to decrease at high altitude. 19 Eosinophilia in patients living at low altitude may be attributed to better response to steroid treatment and greater number in the early stage.…”