慢性阻塞性肺疾病急性加重患者血小板淋巴细胞比值与90天死亡率的评估
Evaluation of platelet lymphocyte ratio and 90-day mortality in patients with acute exacerbation of chronic obstructive pulmonary disease.
作者信息
Kumar Praneel, Law Stephanie, Sriram Krishna B
机构信息
School of Medicine, Parklands Drive, Griffith University, Southport, Queensland 4215, Australia.
Department of Respiratory Medicine, Gold Coast University Hospital, Southport, Queensland 4215, Australia.
出版信息
J Thorac Dis. 2017 Jun;9(6):1509-1516. doi: 10.21037/jtd.2017.05.77.
BACKGROUND
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have high mortality and health care costs. The platelet to lymphocyte ratio (PLR) is a marker of inflammation and has been reported to be elevated in patients with AECOPD compared to stable state. In this study, we sought to evaluate the association of the PLR in patients with AECOPD with 90-day mortality.
METHODS
We conducted a retrospective cohort study of patients admitted to our institution with a primary diagnosis of AECOPD between January 2014 and July 2014. Blood test results on admission were recorded. The primary outcomes were 90-day mortality.
RESULTS
One hundred and eighty-one AECOPD patients were considered for the study. Death had occurred in 16 (9%) patients within 90 days of hospital discharge. Univariable analysis identified age, haemoglobin, neutrophil count, and urea level, neutrophil lymphocyte ratio (NLR) and PLR as being associated with increased 90-day mortality. Multivariable logistic regression analysis variables demonstrated that only PLR (P=0.03) was significantly associated with death at 90 days. Receiver operator characteristic analysis identified PLR ≥235 had a sensitivity of 63% and specificity of 74% in predicting 90-day mortality. PLR was ≥235 was also associated with worse survival (days) [mean ± standard deviation (SD): PLR ≥235 PLR <235: 512±358 626±346, P=0.004].
CONCLUSIONS
A PLR ≥235 was significantly associated with 90-day mortality, which may provide prognostic guidance to clinicians.
背景
慢性阻塞性肺疾病急性加重（AECOPD）具有较高的死亡率和医疗成本。血小板与淋巴细胞比值（PLR）是一种炎症标志物，据报道，与稳定期患者相比，AECOPD患者的PLR升高。在本研究中，我们试图评估AECOPD患者的PLR与90天死亡率之间的关联。
方法
我们对2014年1月至2014年7月期间因AECOPD为主诊断入住我院的患者进行了一项回顾性队列研究，并记录入院时的血液检测结果。主要结局为90天死亡率
结果
181例AECOPD患者纳入研究分析。16例（9%）患者在出院后90天内死亡。单变量分析确定年龄、血红蛋白、中性粒细胞计数、尿素水平、中性粒细胞淋巴细胞比值（NLR）和PLR与90天死亡率增加相关；多变量逻辑回归分析显示，只有PLR（P=0.03）与90天死亡率显著相关；受试者工作特征分析确定，PLR≥235预测90天死亡率的敏感度为63%，特异度为74%；PLR≥235还与较差的生存天数相关（均值±标准差：PLR≥235组与PLR<235组分别为512±358和626±346天，P=0.004）。
结论
PLR≥235与90天死亡率显著相关，可为临床医生提供预后指导。
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