Relationship between neutrophil-lymphocyte ratio and short-term prognosis in the chronic obstructive pulmonary patients with acute exacerbation

Abstract

We retrospectively collected data from a large sample size of population and explore the relationship between neutrophil-lymphocyte ratio (NLR) and adverse outcomes, and assessed the clinical prognostic utility of NLR in patients with chronic obstructive pulmonary patients with acute exacerbation (AECOPD). We reviewed 3 years medical case records, 622 patients were identified including 48 died and 574 alive. Compared with alive group, the died group had significantly elevated neutrophils, lymphocyte, and NLR level (P<0.001). The high-sensitive C-protein level of died group was also higher compared with alive group (7.48 ± 4.2 vs 1.26 ± 0.56, vs P<0.001). The univariate logistic regression indicated that elevated NLR level was associated with the increased of adverse outcome (odds ratio [OR] = 4.59, 95% CI: 2.27-8.94, P<0.001). After adjusted potential confounding factors, the elevated NLR level was still associated with adverse outcomes in the chronic obstructive pulmonary patients with acute exacerbation (OR = 2.05, 95% CI: 1.21-3.48, P=0.008). The area under the receiver operating characteristic curve for death at 90 days was 0.742 (95% CI: 0.554-0.881). NLR cutoff of >4.19 had a sensitivity of 71.4% and specificity of 74.2%. Our results suggested that NLR, as a rapid, inexpensive and easily obtained blood routine index was associated with short-term adverse outcomes in patients with AECOPD. The elevated NLR predicted the increased the risk of 90-day mortality in patients with AECOPD.

Keywords: COPD; chronic obstructive pulmonary patients; neutrophil-lymphocyte ratio; prognosis.

Figure 1. ROC curve of NLR in identifying the prognosis of AECOPD