Abstract
Objectives: The blood neutrophil to lymphocyte ratio (NLR) has been identified as a potentially useful marker of clinical outcome in disease states with an inflammatory component. We have investigated the role of NLR in the prediction of long-term mortality in patients with chronic obstructive pulmonary disease (COPD).
Methods: This is a retrospective observational cohort study in which 129 patients with COPD were enrolled. Patients with cancer disease, ischemic heart disease, and systemic infections and chronic inflammatory diseases were excluded from the study. The primary end point was survival during follow-up. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal NLR cutoff level with regard to mortality.
Results: There were 107 men and 22 women, mean age 69.4±10.6 years. The mean follow-up duration was 32±5 months, during which 32 patients with COPD died. The mean NLRs were 2.3±1.2 and 4.42±3.8 in surviving and nonsurviving patients, respectively (P<0.001). Kaplan-Meier survival analysis was carried out according to the median NLR above and below 3 based on ROC analysis. Patients with NLR of at least 3 had a significantly lower survival (log rank, P<0.001). NLR was found to be an independent predictor of mortality in all Cox Regression models (hazard ratio 1.4; 95% confidence interval 1.3-1.5; P<0.001).
Conclusion:NLR, which is quick, cheap, easily measurable property with routine complete blood count analysis, is a predictor of mortality in patients with COPD.
- © 2014 ERS