Relationship between neutrophil–lymphocyte ratio and short-term prognosis in the chronic obstructive pulmonary patients with acute exacerbation

Abstract

We retrospectively collected data from a large sample size of population and explore the relationship between neutrophil–lymphocyte ratio (NLR) and adverse outcomes, and assessed the clinical prognostic utility of NLR in patients with chronic obstructive pulmonary patients with acute exacerbation (AECOPD). We reviewed 3 years medical case records, 622 patients were identified including 48 died and 574 alive. Compared with alive group, the died group had significantly elevated neutrophils, lymphocyte, and NLR level ( P<0.001). The high-sensitive C-protein level of died group was also higher compared with alive group (7.48 ± 4.2 vs 1.26 ± 0.56, vs P<0.001). The univariate logistic regression indicated that elevated NLR level was associated with the increased of adverse outcome (odds ratio [OR] = 4.59, 95% CI: 2.27–8.94, P<0.001). After adjusted potential confounding factors, the elevated NLR level was still associated with adverse outcomes in the chronic obstructive pulmonary patients with acute exacerbation (OR = 2.05, 95% CI: 1.21–3.48, P=0.008). The area under the receiver operating characteristic curve for death at 90 days was 0.742 (95% CI: 0.554–0.881). NLR cutoff of >4.19 had a sensitivity of 71.4% and specificity of 74.2%. Our results suggested that NLR, as a rapid, inexpensive and easily obtained blood routine index was associated with short-term adverse outcomes in patients with AECOPD. The elevated NLR predicted the increased the risk of 90-day mortality in patients with AECOPD.