Prognostic Value of Neutrophil:Lymphocyte and Platelet:Lymphocyte Ratios for 28-Day Mortality of Patients with AECOPD

Figures & data

Table 1 Comparison of general characteristics between death group and survival group

Clinical characteristic	Overall (n=533)	Survival group (n=485)	Death group (n=48)	p
Age (years)	75.71±9.92	74.76±9.95	80.87±8.66	<0.001
Sex, n (%)
Male	355(66.60%)	325(67.01%)	30(62.50%)	0.525
Female	178(33.40%)	160(32.99%)	18(37.50%)
Smoking history, n (%)
Current/ever-smoker	338(63.41%)	300(61.86%)	38(79.17%)	0.022
Never-smoker	195(36.59%)	185(38.14%)	10(20.83%)
BMI (kg/m^2)	20.74±3.55	21.16±3.73	19.40±2.49	0.675
Pulmonary function
FEV1 (L)	0.98±0.43	1.02±0.55	0.95±0.49	0.245
FEV1/FVC	54.84±9.93	55.13±10.32	52.17±8.85	0.334
FEV1% predicted	43.09±7.61	45.72±8.03	39.23±5.56	<0.001
pH	7.40±0.08	7.42±0.09	7.37±0.06	0.073
PaCO2 (mmHg)	53.14±16.73	51.58±14.70	63.03±17.36	<0.001
PaO2 (mmHg)	70.0±10.26	70.90±10.21	65.94±9.43	0.002
WBCs (×10^9/L)	9.35±4.35	8.76±4.23	12.14±3.91	<0.001
Neutrophils (×10^9/L)	7.58±5.49	6.81±5.68	10.60±3.97	<0.001
Lymphocytes (×10^9/L)	1.12±0.67	1.22±0.75	0.86±0.67	<0.001
Platelets (×10^9/L)	211.20±87.65	213.97±81.95	200.03±109.21	0.407
Monocytes (×10^9/L)	0.64±0.37	0.64±0.33	0.62±0.52	0.663
NLR	9.02±6.54	8.51±6.08	15.12±12.99	<0.001
PLR	220.99±95.32	211.92±89.57	284.70±131.73	<0.001
LMR	2.20±1.75	2.26±1.79	1.62±1.19	0.061
CRP	45.67±21.66	43.79±19.91	64.65±28.68	<0.001
D-dimer (ng/mL)	461.11±138.99	350.56±105.07	933.27±238.88	<0.001
Fibrinogen (g/L)	4.09±2.16	4.15±2.28	3.85±1.56	0.386
Cr (µmol/L)	81.92±52.35	77.46±47.51	101.00±66.64	0.005
BUN (mmol/L)	7.86±1.94	7.21±1.81	10.63±1.99	0.007
Albumin (g/L)	35.11±7.09	34.56±5.42	37.42±10.65	0.645
LDH (U/L)	227.55±85.68	212.64±84.14	291.23±88.92	0.001

Abbreviations: NLR, neutrophil:lymphocyte ratio; PLR, platelet:lymphocyte ratio; LMR, lymphocyte:monocyte ratio; Cr, creatinine; BUN, blood-urea nitrogen; LDH, lactate dehydrogenase; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity.

Table 2 Comparison of clinical parameters at admission versus at 7–10 days after hospitalization in death and survival groups

		WBC (×10^9/L)	Neutrophils (×10^9/L)	Lymphocytes (×10^9/L)	NLR	PLR	CRP
Survival group	At admission	8.76±4.23	6.81±5.68	1.22±0.75	8.51±6.08	211.92±89.57	43.79±19.91
	At 7–10 days	6.83±3.23	6.94±6.01	2.08±0.89	6.77±4.87	193.74±77.34	21.63±9.39
Death group	At admission	12.14±3.91	10.60±3.97	0.86±0.67	15.12±12.99	284.70±131.73	64.65±28.68
	At 7–10 days	15.91±5.65	13.45±4.50	0.69±0.43	18.98±24.34	302.26±144.24	88.76±34.91
		PaCO2 (mmHg)	PaO2 (mmHg)	D-dimer (ng/mL)	Cr (µmol/L)	BUN (mmol/L)	LDH (U/L)
Survival group	At admission	51.58±14.70	70.91±10.21	350.56±105.07	77.46±47.51	7.21±1.81	212.64±84.14
	At 7–10 days	50.48±12.37	75.89±11.38	335.83±101.23	69.82±42.29	6.38±1.56	213.87±84.85
Death group	At admission	63.03±17.36	65.94±9.43	933.27±238.88	101.02±66.64	10.63±1.99	291.23±88.92
	At 7–10 days	71.39±19.87	59.56±7.67	945.54±276.56	106.67±71.15	11.47±2.28	322.74±98.90

Table 3 Univariate logistic regression analysis of risk factors associated with 28-day mortality for AECOPD patients

Parameter	β	SE	Wald x^2	P	OR	95% CI
Age (years)	0.07	0.02	11.39	0.001	1.07	1.03–1.27
Smoking history	0.37	0.33	1.04	0.015	1.27	0.56–3.04
FEV1% predicted	−0.41	0.15	14.78	0.004	0.96	0.95–0.99
PaCO2 (mmHg)	1.06	0.21	31.14	0.065	1.36	1.04–2.28
PaO2 (mmHg)	0.95	0.32	9.15	0.072	1.95	1.92–2.98
WBCs (×10^9/L)	0.90	0.25	2.18	0.341	0.41	0.29–2.21
Neutrophils (×10^9/L)	1.02	0.44	11.20	<0.001	3.98	1.91–7.06
Lymphocytes (×10^9/L)	1.73	0.38	21.36	0.007	1.79	2.37–11.69
NLR	1.08	0.43	59.76	<0.001	4.09	1.03–9.14
PLR	2.00	0.60	37.59	<0.001	4.03	1.33–11.01
CRP	1.03	0.61	8.16	<0.001	3.03	1.84–3.05
D-dimer (ng/mL)	1.53	0.51	32.62	0.105	1.08	0.87–1.54
Cr (µmol/L)	1.69	0.16	34.09	0.073	1.01	0.47–2.01
BUN (mmol/L)	0.71	0.33	21.77	0.018	1.87	0.99–2.03
LDH (U/L)	0.82	0.42	4.84	0.360	1.72	0.98–1.97

Table 4 Multivariate logistic regression analysis of risk factors associated with 28-day mortality for AECOPD patients

Parameter	β	SE	Wald χ^2	P	OR	95% CI
Age (years)	0.12	0.08	10.34	0.672	0.79	0.65–1.44
Smoking history	0.88	0.74	17.38	0.026	2.02	1.78–5.13
FEV1% predicted	−0.34	0.32	15.28	0.034	0.97	0.96–0.99
Neutrophils (×10^9/L)	1.21	0.54	12.34	0.002	1.78	1.35–6.31
Lymphocytes (×10^9/L)	1.64	0.33	18.79	0.083	1.04	1.86–10.37
NLR	1.22	0.52	52.28	<0.001	3.87	1.29–10.30
PLR	2.15	0.58	33.89	0.005	3.45	1.43–12.62
CRP	1.14	0.38	7.73	<0.001	2.58	1.59–4.47
BUN (mmol/L)	0.77	0.41	17.76	0.076	0.88	0.76–2.78

Figure 1 Receiver-operating characteristic (ROC) curves of NLR, PLR, and CRP, singly and combined, for predicting 28-day mortality of patients with acute exacerbation of chronic obstructive pulmonary disease. ROC curves for single predictors had areas of 0.801 (NLR), 0.750 (PLR), and 0.740 (CRP) . Combined predictors of NLR, PLR, and CRP had the best AUC of 0.857.