Correlation of neutrophil to lymphocyte with acute exacerbation in chronic obstructive pulmonary disease at tertiary care hospital in North West Rajasthan

Abstract

Acute exacerbation of COPD (AECOPD), is one of the most common disease in patients with infections, having frequent hospitalization. The aim of this study is to evaluate the potential for NLR to be used as a biomarker of COPD exacerbation. The hospital based case control Study is was conduct on hospitalized 100 patient with primary and final diagnosis of AECOPD and 100 patient of stable period of COPD. Socio-demographic variable in both groups were comparable. BMI was significantly lower in AECOPD patients. The mean PACK/YR in AECOPD group was 29.52±3.70 and in Stable COPD was 23.50±2.05. FEV1was significantly lower in AECOPD patients. Mean admission per year was significantly higher in AECOPD patients. Mean neutrophil count was significantly higher in AECOPD patients (11.49±2.32) as compare to stable COPD patients (6.47±2.01). Mean lymphyocyte count was significantly higher in AECOPD patients (2.07±0.05) as compare to stable COPD patients (1.71±0.07). Mean NLR was significantly higher in AECOPD patients (5.54±2.12) as compare to stable COPD patients (3.77±0.22). The difference in both groups was found statically significant. 5.00% hospital mortality in AECOPD patients. Mean neutrophil count was significantly higher in death as compare to survived patients. Mean NLR was significantly higher in death as compare to survived patients. NLR is readily available (Available at PHC) and simple parameter, could also be used as a cost-effective marker of inflammation in AECOPD. We have concluded that the neutrophil lymphocyte ratio on the day of presenting the illness was significantly higher in AECOPD as compare to stable COPD. Those patients who had a high NLR during admission were associated with poor survival.