Abstract
Objectives: To investigate the clinical features of severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in frequent exacerbators, and explore the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for outcome in this phenotype during severe exacerbation.
Methods: Included severe AECOPD patients were identified as frequent exacerbators if they experienced two or more exacerbations in the past year. Clinical characteristics and worse outcome during severe AECOPD were compared between frequent exacerbators and non-frequent ones. The relationship between NLR and worse outcome in frequent exacerbators was also analyzed.
Results: Among 604 patients with severe AECOPD, 282 were frequent exacerbators and 322 were non-frequent exacerbators. Compared with the non-frequent ones, frequent exacerbators presented higher levels of NLR (5.93 vs 4.41; p<0.001) and more worse outcome incidence (20.57% vs 11.80%; p=0.003). Among the frequent exacerbators, NLR levels in the patients with worse outcome were much higher than in those without worse outcome (11.09 vs 5.28; p<0.001). Increased NLR was significantly associated with a higher risk of worse outcome in frequent exacerbators (OR, 1.43; 95%CI, 1.28-1.64; p<0.001). Furthermore, ROC analysis revealed that a cut-off value of 10.23, NLR could predict worse outcome of severe AECOPD in frequent exacerbators (sensitivity 62.1%, specificity 92.0%, AUC 0.833).
Conclusion: Frequent exacerbators exhibited an increased level of NLR and a higher proportion of worse outcome during severe AECOPD. NLR is expected to be a promising predictive biomarker for the prognosis of severe AECOPD in frequent exacerbators.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3825.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021