Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder marked by airflow limitation and persistent symptoms. Acute exacerbations significantly increase morbidity, mortality, and impair quality of life. The neutrophil-to- lymphocyte ratio (NLR), a simple and inexpensive biomarker of systemic inflammation, has been suggested as a potential predictor of COPD exacerbations. This study aimed to assess the relationship between NLR and exacerbation status in COPD patients. Methods A cross-sectional observational study was performed in patients diagnosed with COPD according to GOLD 2023 criteria at an outpatient pulmonary clinic. Demographic and clinical data, exacerbation frequency, and complete blood counts were collected. NLR was calculated from peripheral blood, and statistical analyses included Mann-Whitney U and Spearman’s correlation tests. Results Sixty patients were enrolled, equally distributed into stable (n = 20), mild exacerbation (n = 20), and moderate exacerbation (n = 20) groups. Demographic characteristics such as age, BMI, and smoking history did not differ significantly (p 0.05). In contrast, NLR showed a strong and significant association with exacerbation status. Elevated NLR was found in 47.4% of mild exacerbations (OR = 21, 95% CI: 3.7-120.4, p = 0.001) and in 36.8% of moderate exacerbations (OR = 27, 95% CI: 4.6-159.7, p 0.001), while most stable patients had normal values. Conclusion Elevated NLR is significantly associated with mild and moderate COPD exacerbations. NLR may serve as a simple, inexpensive, and reliable biomarker for identifying patients at higher risk of exacerbations and could support clinical monitoring strategies. This abstract is funded by: none
L et al. (Fri,) studied this question.