中性粒细胞百分比/白蛋白比值在预测因社区获得性肺炎住院的慢性阻塞性肺疾病患者1个月死亡率中的临床应用价值。
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.
作者信息
Gul Sule, Uysal Mehmet Atilla, Yeter Ayse, Eren Ramazan, Demirkol Barıs, Niksarlıoglu Elif Yelda Ozgun
机构信息
Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Chest Diseases, University of Health Sciences, Istanbul, 34020, Turkey.
Başakşehir Çam and Sakura City Hospital, Chest Diseases, University of Health Sciences, Istanbul, 34480, Turkey.
出版信息
BMC Pulm Med. 2025 Jun 9;25(1):288. doi: 10.1186/s12890-025-03757-z.
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, :0.01 and HR:6.853, :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, :0.005). Furthermore, higher NPAR was associated with disease severity, prolonged hospital stays, and treatment-related mortality (all < 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.
背景
社区获得性肺炎（CAP）是慢性阻塞性肺疾病（COPD）患者住院治疗的重要原因，对发病率和死亡率均有负面影响。中性粒细胞百分比与白蛋白比值（NPAR）是一种新近提出的综合反映全身炎症和营养状况的指标。本研究旨在明确NPAR对预测因CAP住院的COPD患者1个月死亡率的预后意义。
方法
回顾性分析2014年1月1日至2020年12月31日研究人群的病历。计算入院时的NPAR值。采用Cox比例风险模型研究NPAR、log NPAR与1个月死亡率之间的关联。进行受试者工作特征（ROC）分析，以比较log NPAR与既定临床评分系统的预测价值。
结果
本研究共纳入508例患者。在对年龄和性别进行校正后的Cox分析中，较高的NPAR和log NPAR与1个月死亡率显著相关（HR：2.175，P = 0.01；HR：6.853，P = 0.031）。然而，在对其他混杂因素进行校正后，NPAR和log NPAR与1个月死亡率不再显著相关。ROC分析表明，与肺炎严重指数（PSI）和CURB-65评分相比，log NPAR对1个月死亡率具有更好的预测价值（log NPAR的AUC为0.654，PSI为0.596，CURB-65为0.569，P = 0.005）。此外，较高的NPAR与疾病严重程度、住院时间延长及治疗相关死亡率相关（均P < 0.05）。
结论
NPAR可能是评估COPD合并CAP患者1个月死亡率、疾病严重程度及治疗结局的有用生物标志物。需要进一步研究以确定其在指导治疗决策中的作用。
Zotero 插件