Eosinophilic and non-eosinophilic COPD patients with chronic respiratory failure: neutrophil-to-lymphocyte ratio as an exacerbation marker

• DOI: 10.2147/copd.s147261
• Publication Date: 2017-11-22T22:26:52Z
• Authors: Eylem Acartürk Tu...; Zuhal Karakurt; Emine Aksoy; Cüneyt Saltürk; Sinem Gungor; Nezihe Cıftaslan; Ilim Irmak; Dilek Yavuz; Birsen Ocakli; Nalan Adıgüzel
• Keywords: Male; Neutrophils; Clinical Decision-Making; International Journal of Chronic Obstructive Pulmonary Disease; chronic obstructive pulmonary disease; Diseases of the respiratory system; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; exacerbation; 0302 clinical medicine; Predictive Value of Tests; Eosinophilia; Humans; Lymphocyte Count; Lymphocytes; chronic respiratory failure; neutrophil to lymphocyte ratio; Lung; Original Research; Aged; RC705-779; Middle Aged; Prognosis; 3. Good health; Eosinophils; Cross-Sectional Studies; ROC Curve; Area Under Curve; Disease Progression; Female; Respiratory Insufficiency; peripheral eosinophilia.

Aim: Increased dyspnea, sputum volume, and purulence are subjective symptoms in COPD patients. To diagnose exacerbations with chronic respiratory failure (CRF) to assess the requirement for antibiotic treatment, physicians require more objective criteria. We aimed investigate whether neutrophil-to-lymphocyte ratio (NLR) can be used as an infectious exacerbation marker patients CRF. Patients methods: This retrospective cross-sectional study was performed intensive care outpatient clinic of a tertiary training hospital between 2014 2015. admitted CRF due who had complete blood count (CBC) results were enrolled. CBC C-reactive protein (CRP) levels obtained from online database. The "modified model (MEM)" defined follows: A, leukocytes ≥12,000/mm 3 , CRP >10 mg/dL; B, ≥10,000/mm C, >8 D, >5 mg/dL. cutoff value NLR each model. split into two groups based on according "NLR model" further subgrouped peripheral eosinophil percentage (eosinophils ≥2% <2%) compared MEM. Results: A total 1,066 (430 females, 40.3%), mean age 66±13 years, included. 3.54 (NLR ≥3.54, n=366, 34%) showed highest sensitivity specificity (78%, 69%), B (63%, 71%), C (61%, 72%), D (58%, 72%). Peripheral eosinophilia (PE ≥2%) present 48 (4.5%). PE <2% ≥3.54 group significantly higher MEM ( P <0.001). Conclusion: presents attractive option its simplicity cost-effectiveness. In CRF, where is <2%, present, treatment should considered. Keywords: COPD, exacerbation, failure, ratio,