Neutrophil-to-lymphocyte ratio as a biomarker associated with chronic obstructive pulmonary disease severity and acute exacerbation

Abstract

Chronic obstructive pulmonary disease (COPD) is a significant public health issue and ranks among the leading causes of morbidity and mortality globally. This work aimed to examine the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the clinical and functional outcomes of COPD, as well as the NLR’s usefulness in identifying or anticipating the diagnosis of acute exacerbation. This prospective case–control study was carried out on 90 individuals in the Chest Department at Tanta University hospitals. All patients were divided into three equal groups: group I: stable COPD, group II: acute exacerbated COPD patients, and group III: healthy participants who were age and sex matched with the cases as the control group. The multivariate logistic regression analysis showed that smoking index, COPD assessment test score, modified Medical Research Council, BODE index, forced expiratory volume in 1 s/forced vital capacity, forced expiratory volume in 1 s%, and NLR were significant predictors of the incidence of future exacerbation. NLR is a significant biomarker of inflammation in addition to its ability to predict future exacerbation at a cutoff more than 2.5 and a marker of increased inflammation during exacerbation and thus it can detect acute exacerbations of COPD at more than 3.2 cutoff as well as predict in-hospital mortality at a cutoff more than 6.5.