The Prognostic Significance of Advanced Lung Cancer Inflammation Index in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Using Noninvasive Ventilatory Support

Abstract

Background The advanced lung cancer inflammation index (ALI) is an important characteristic of cancer and other diseases. This retrospective study aimed to explore the prognostic value of the ALI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) using noninvasive ventilation (NIV). Methods This is a retrospective cohort study. A nonrandom sampling method was employed to collect the inpatients diagnosed with AECOPD and used noninvasive ventilators in the Department of Respiratory and Critical Medicine, Beijing Chao‐yang Hospital, affiliated with Capital Medical University, from January 2017 to December 2022. Participants were categorized into a success group (NIV‐S) and a failure group (NIV‐F) based on the outcome of their noninvasive ventilator use in hospitals. The laboratory indices of both groups were compared. A multivariate logistic regression analysis was conducted to identify the risk factors influencing patient prognosis when using noninvasive ventilators, and the subject working a characteristic curve was employed to assess the predictive power of associated risk factors for the failure of noninvasive ventilators. Results A total of 137 patients suffering from AECOPD complicated with respiratory failure were included, including 117 cases in the NIV successful group (NIV‐S, 85.4%) and 20 cases in the NIV failed group (NIV‐F, 14.6%). The arterial blood carbon dioxide partial pressure (PaCO2), fibrinogen, and urea nitrogen in the NIV‐S were lower. At the same time, the total protein, albumin, body mass index (BMI), and ALI were higher than those in the NIV‐F. Moreover, our data revealed that ALI could be considered a reliable biomarker for predicting NIV‐F (AUC: 0.822 and 95% CI: 0.710–0.934). The ALI group, along with an OR of 12.206 (95% CI: 3.086–48.279; p < 0.001). Conclusions Low ALI is associated with NIV‐F in patients with AECOPD and is a practical and valuable tool for prognostic assessment.