Neutrophil-to-Lymphocyte Ratio in Chronic Obstructive Pulmonary Disease Exacerbators presenting to Emergency: A Marker of Disease Severity and Poor Outcomes

Muhammad Mahad Qureshi; Muhammad Nadeem  Ashraf; Sobia  Mariam; Syed Muhammad Hassan  Kazmi; Muhammad Farrukh  Habib; Wajid  Ali

doi:10.51253/pafmj.v75iSUPPL-7.10784

Authors

Muhammad Mahad Qureshi Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Nadeem Ashraf Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Sobia Mariam Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Syed Muhammad Hassan Kazmi Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Farrukh Habib Department of Community Medicine, Alhamd Islamic University, Islamabad Pakistan
Wajid Ali Department of Emergency Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-7.10784

Keywords:

Lymphocytes, Neutrophils, Pulmonary disease

Abstract

Objective: To determine the predictive value of Neutrophil-to-Lymphocyte Ratio in COPD Exacerbation as a marker of disease severity and poor outcomes.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Emergency, Pakistan Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2022 to Jun 2023.

Methodology: 150 patients with severe Acute Exacerbations of Chronic Obstructive Pulmonary Disease were enrolled in the study. Convenience sampling was performed. Patients were divided into 3 groups based upon value of Neutrophil to Lymphocyte ratio with 50 patients in each group. Neutrophil to Lymphocyte ratio in Group-A was 0-4, Group-B was 4.1-8 and for Group-C it was 8.1-12. Patients were evaluated for hospital admissions, need for mechanical ventilation and rate of mortality.

Results: Out of 150 patients, Group-A had 4 (8%) hospital admissions and 1 (2%) mortality, Group-B 15 (30%) had hospital admissions, and 5(10%) mortality and Group-C had 30(60%) hospital admissions and 10(20%) had mortality. Higher Neutrophil to Lymphocyte ratio is a marker for severity and poor outcomes.

Conclusion: Higher NLR was linked to disease severity and associated poor outcomes in COPD exacerbators. As a result, the NLR's utility in COPD patients should be investigated further in clinical settings in the future. If a COPD exacerbation has an NLR of 3.5-4.0, the patient may be considered eligible for outpatient follow-up without hospitalization. If the NLR is 7.5-8.0, we propose ward hospitalization; if the NLR is 11.0-12, we recommend ICU admissions.

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