Factors associated with neutrophil-to-lymphocyte ratio to predict exacerbation in chronic obstructive pulmonary disease

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world due to severity and inflammation complications. Neutrophil-to-lymphocyte ratio (NLR) in blood tests can be used as a biomarker of inflammation because it is quick and easy, cost-effective, and can be done routinely. The aim of this study is to evaluate the potential value of NLR to be used as an inflammatory biomarker and to reflect COPD exacerbation.METHODS: A retrospective cohort study was conducted on 89 COPD patients in Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi, Indonesia. Demographic and clinical data were collected by collecting medical record data from patients who were examined in Department of Pulmonology and Respiratory Medicine, and Clinical Laboratory of Dr. Wahidin Sudirohusodo Central Hospital. The cut-off value of NLR in COPD patient was analyzed by receiver operating characteristic (ROC) for exacerbation. Significant values were determined at P<0.05.RESULTS: Smoking history, comorbidity and degree of severity group are the factors associated with NLR value. NLR cut-off value to predict exacerbation is 5.04 with 81.6% and 80% specificity and sensitivity respectively with area under curve (AUC) 0.87.CONCLUSIONS: NLR positively correlates with smoker history, patient comorbidity and degree of severity group. NLR could be used as sensitive and specific predictor of exacerbation in stable COPD patients.