Prognostic role of neutrophil - lymphocyte ratio and platelet - lymphocyte ratio for hospital mortality in patients with AECOPD

Abstract

Background &Aim: Chronic obstructive pulmonary disease (COPD) exacerbation are one of the most common and most important hospitalization diseases in the world and are associated with increased mortality rates. In addition, the patient may need mechanical ventilation, which exposes him to its complications and long-term complications of lying down, which increases the mortality rate significantly. Therefore, it is necessary to search for warning signals that help us in predicting the predicting the risk of death in the exacerbation.

This research aim to Study of the prognostic role of NLR and PLR in hospital mortality in patients admitted to acute exacerbation of COPD.

Materials and Methods: A cohort cohort study was conducted on (153) patients with an acute exacerbation of COPD at Al-Assad and Al-Muwasat University Hospitals in Damascus during the period between 2019-2020.

The CBC test was done and the NLR and PLR ratios were calculated upon admission, then the patient's development was monitored until discharge from the hospital or death, and then a statistical study was conducted to find out whether or not there was a relationship between these two ratios and the risk of death.

Results: The NLR plays an important prognostic role in predicting the hospitalized mortality of acute-attack COPD patients with high sensitivity and specificity where the cut-off value = 7.16 with a sensitivity of 81.8% and a specificity of 84% and the AUC was 0.841

The PLR ​​also plays an important prognostic role in predicting nosocomial mortality in acute-onset COPD patients, but the sensitivity and specificity are lower than in the NLR where the cut-off value = 183.49 with a sensitivity of 68.2% and a specificity of 67.9% and the AUC was 0.661

While the sensitivity and specificity for CRP were 72.7% and 66.4%, respectively.

Thus, we can say that the NLR is the best indicator in terms of sensitivity and specificity for predicting hospitalized mortality in COPD patients, followed by CRP in terms of sensitivity and PLR in terms of specificity.

Conclusion: The NLR and PLR is a simple and useful predictor of in-hospital mortality in patients with AECOPD. A routine CBC blood test is available and affordable for every patient with AECOPD; The utility of the NLR calibration may be better than that of other prognositic maker like CRP or Procalcitonin, which may require specific equipment or a detector.