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. 2025 Jun 9;25(1):288.
doi: 10.1186/s12890-025-03757-z.

The clinical usefulness of neutrophil percentage/albumin ratio in predicting the one-month mortality in chronic obstructive pulmonary disease patients hospitalized with community-acquired pneumonia

Sule Gul  1 , Mehmet Atilla Uysal  2 , Ayse Yeter  2 , Ramazan Eren  2 , Barıs Demirkol  3 , Elif Yelda Ozgun Niksarlıoglu  2
Affiliations

The clinical usefulness of neutrophil percentage/albumin ratio in predicting the one-month mortality in chronic obstructive pulmonary disease patients hospitalized with community-acquired pneumonia

Sule Gul et al. BMC Pulm Med. .

Abstract

Background: Community-acquired pneumonia (CAP) is a significant cause of hospitalization in chronic obstructive pulmonary disease (COPD), negatively impacting both morbidity and mortality. The neutrophil percentage-to-albumin ratio (NPAR) is a recently introduced indicator combining systemic inflammation and nutritional status. This study aimed to clarify the prognostic significance of NPAR in predicting one-month mortality among COPD patients hospitalized with CAP.

Methods: Medical records of the study population between January 1, 2014, and December 31, 2020, were retrospectively reviewed. NPAR values at admission were calculated. The Cox proportional hazards model was used to investigate the association between the NPAR, log NPAR, and one-month mortality. Receiver operating characteristic (ROC) analysis was performed to compare the predictive value of log NPAR with established clinical scoring systems.

Results: A total of 508 patients were included in the study. Higher NPAR and log NPAR were significantly associated with one-month mortality in Cox analysis after adjustment for age and gender (HR:2.175, p:0.01 and HR:6.853, p:0.031). However, after adjusting for additional confounding factors, NPAR and long NPAR were no longer significantly associated with one-month mortality. ROC analysis demonstrated that log NPAR had a superior predictive value for one-month mortality compared to PSI and CURB-65 scores (AUC for log NPAR: 0.654, for PSI: 0.596, and CURB-65: 0.569, p:0.005). Furthermore, higher NPAR was associated with disease severity, prolonged hospital stays, and treatment-related mortality (all p < 0.05).

Conclusions: NPAR may be a useful biomarker for assessing one-month mortality, disease severity, and treatment outcomes in COPD patients with CAP. Further research is needed to determine its role in guiding therapeutic decisions.

Keywords: Albumin; COPD; Community acquired pneumonia; Mortality; Neutrophil.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study adhered to the principles outlined in the Declaration of Helsinki and was carried out with the approval of the University of Health Sciences Ethical Committee (11/12-2024/11). The requirement for informed consent was waived by the Institutional Review Board due to the retrospective nature of the study and the use of anonymized clinical data. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Flowchart of the study population
Fig. 2
Fig. 2
ROC curves for the prediction of one-month mortality in COPD patients hospitalized with community-acquired pneumonia
See this image and copyright information in PMC

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