Eraslan Doganay Guler, Cirik Mustafa Ozgur
Anesthesiology and Reanimation, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, TUR.
Cureus. 2022 Mar 26;14(3):e23499. doi: 10.7759/cureus.23499. eCollection 2022 Mar.
Background and objective Chronic obstructive pulmonary disease (COPD) is a condition in which the expiratory airflow is restricted and is characterized by inflammation. Recently, inflammation-related biomarkers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) have been used to predict the prognosis in COPD. The aim of this study was to evaluate the role of biomarkers such as NLR, PLR, and MLR in COPD patients in intensive care and to examine the ability of these markers to predict the prognosis [length of stay in hospital (LOSH), duration of mechanical ventilation (MV), length of stay in ICU (LOS ICU), and mortality]. Methods A total of 562 patients who were treated in the ICU between 2018 and 2019 were retrospectively reviewed. Among them, 369 were patients with COPD. We evaluated clinical data including patient demographics, Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, LOS ICU, LOSH, duration of MV, as well as NLR, PLR, and MLR values. Data on patient deaths (30-day mortality) was obtained from the Death Notification System. Results Age, LOSH, CCI, and SOFA were found to predict mortality in COPD patients. In cases with mortality, age, inotropic use, MV duration, LOS ICU, APACHE II, CCI, SOFA, lymphocyte count, neutrophil count, platelet count, monocyte count, NLR, PLR, and MLR levels were statistically significantly higher than those in cases without mortality. There was a positive and low statistically significant relationship of NLR, PLR, and MLR with prognostic factors like MV duration, APACHE II scores, and SOFA scores. Conclusion The NLR, PLR, and MLR values may be used as prognostic indicators in COPD patients in intensive care. Although there are many studies endorsing the use of biomarkers such as NLR, PLR, and MLR as prognostic indicators, further comparative studies on this subject are still required to gain deeper insights into the topic.
背景与目的 慢性阻塞性肺疾病（COPD）是一种呼气气流受限且以炎症为特征的疾病。最近，中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及单核细胞与淋巴细胞比值（MLR）等炎症相关生物标志物已被用于预测COPD的预后。本研究的目的是评估NLR、PLR和MLR等生物标志物在重症监护的COPD患者中的作用，并检验这些标志物预测预后的能力[住院时间（LOSH）、机械通气时间（MV）、重症监护病房住院时间（LOS ICU）和死亡率]。方法 回顾性分析了2018年至2019年期间在重症监护病房接受治疗的562例患者。其中，369例为COPD患者。我们评估了临床数据，包括患者人口统计学特征、查尔森合并症指数（CCI）、急性生理与慢性健康状况评分系统II（APACHE II）评分、序贯器官衰竭评估（SOFA）评分、LOS ICU、LOSH、MV时间，以及NLR、PLR和MLR值。患者死亡数据（30天死亡率）来自死亡报告系统。结果 年龄、LOSH、CCI和SOFA被发现可预测COPD患者的死亡率。在死亡病例中，年龄、使用血管活性药物、MV时间、LOS ICU、APACHE II、CCI、SOFA、淋巴细胞计数、中性粒细胞计数、血小板计数、单核细胞计数、NLR、PLR和MLR水平在统计学上显著高于未死亡病例。NLR、PLR和MLR与MV时间、APACHE II评分和SOFA评分等预后因素呈正相关且具有较低的统计学显著性。结论 NLR、PLR和MLR值可作为重症监护的COPD患者的预后指标。尽管有许多研究支持使用NLR、PLR和MLR等生物标志物作为预后指标，但仍需要对此主题进行进一步的比较研究，以更深入地了解该主题。
