Importance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic obstructive pulmonary disease exacerbations

Abstract

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammation. Many cells and mediators have been found to be involved in the progression of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the association of the NLR and PLR with treatment options, length of hospital stay, and mortality of patients with COPD exacerbation in this study. MATERIALS AND METHODS: We retrospectively collected the data of COPD patients who were hospitalized with the diagnosis of COPD exacerbation. Demographic data, NLR, PLR, number of exacerbations in the last year, length of hospital stay, and deceased patients were evaluated. Correlations between NLR and PLR with length of hospital stay and treatment options were analyzed. NLR and PLR values were compared between deceased and survived patients. RESULTS: One hundred and nineteen patients were included in the study. The mean age of patients was 68.74 ± 9.2 years, and the mean length of hospital stay was 19.5 ± 13.5 days. The median NLR and PLR values were 3.7 (minimum–maximum: 1–10.8) and 109 (minimum–maximum: 7.4–890), respectively. NLR values were found to be higher in patients who required systemic steroid or invasive mechanical ventilation (IMV) (P = 0.001, P = 0.017). The cutoff value of NLR was 2.65 with 73.8% sensitivity and 54.9% specificity (area under the curve [AUC]: 0.675, P = 0.001) for systemic steroid requirement, and the cutoff value of NLR for IMV requirement was 4.19 with 77.8% sensitivity and 70.4% specificity (AUC: 0.741, P = 0.017). However, PLR values were not related with systemic steroid or IMV. CONCLUSION: NLR seems to be a superior prognostic inflammatory marker than PLR in COPD exacerbation for predicting treatment options.