Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Respir J. 2021 Apr;15(4):382-388. doi: 10.1111/crj.13312. Epub 2020 Dec 1.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has the highest mortality rate and medical costs. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio are inflammatory markers that have been recently linked to the AECOPD severity and patient outcome.
Therefore, the present study aimed at evaluating the diagnostic value of NLR and PLR in the prognosis of the in-hospital mortality in AECOPD patients.
The present retrospective study was performed on 829 AECOPD patients. Age, gender and laboratory results of CBC tests including lymphocyte count, neutrophil count, platelet count, hemoglobin count, white blood cell count (WBC), eosinophil cell count, NLR, PLR and CRP as well as the mortality data were collected from the patients' records and subsequently recorded.
The results of the present study revealed that NLR with the cut-off value of 6.90, sensitivity of 60.87%, and specificity of 73.29% had a significant diagnostic value in the prognosis of in-hospital mortality in AECOPD patients (P < 0.05). A similar significant finding regarding the diagnostic value in the prognosis of in-hospital mortality in AECOPD patients was obtained for CRP with the cut-off value of 30, sensitivity of 73.08%, and specificity of 60.26% (P < 0.05). However, the diagnostic value of PLR in the prognosis of in-hospital mortality in AECOPD patients was found to be insignificant (P = 0.18).
According to the results of the present study, NLR > 6.90 can be considered as a valuable and accurate marker in the prognosis of in-hospital mortality in AECOPD patients.
慢性阻塞性肺疾病(COPD)急性加重(AECOPD)的死亡率和医疗费用最高。中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)是最近与 AECOPD 严重程度和患者预后相关的炎症标志物。
因此,本研究旨在评估 NLR 和 PLR 对 AECOPD 患者住院死亡率预后的诊断价值。
本回顾性研究纳入了 829 例 AECOPD 患者。从患者病历中收集年龄、性别和包括淋巴细胞计数、中性粒细胞计数、血小板计数、血红蛋白计数、白细胞计数(WBC)、嗜酸性粒细胞计数、NLR、PLR 和 CRP 在内的 CBC 检查的实验室结果以及死亡率数据,并随后进行记录。
本研究结果表明,NLR 的截断值为 6.90,其对 AECOPD 患者住院死亡率预后的诊断价值具有显著意义,灵敏度为 60.87%,特异性为 73.29%(P<0.05)。CRP 的截断值为 30,灵敏度为 73.08%,特异性为 60.26%,对 AECOPD 患者住院死亡率预后的诊断价值也具有相似的显著意义(P<0.05)。然而,PLR 对 AECOPD 患者住院死亡率预后的诊断价值不具有显著意义(P=0.18)。
根据本研究结果,NLR>6.90 可被视为预测 AECOPD 患者住院死亡率的有价值且准确的标志物。