Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR), and eosinophil-to-lymphocyte ratio (ELR) as biomarkers in patients with acute exacerbation chronic obstructive pulmonary disease

Abstract

Abstract The study comprehensively evaluated the prognostic roles of the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio. (MLR), basophil-to-lymphocyte ratio (BLR) and eosinophil-to-lymphocyte ratio (ELR) in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD). 619 patients with AECOPD and 300 healthy volunteers were retrospectively included into the study. The clinical characteristics containing laboratory findings of the AECOPD patients and the complete blood counts (CBCs) of the healthy volunteers were collected. Compared with the healthy volunteers, PLR, NLR, MLR, BLR, and ELR were all elevated in COPD patients under stable condition. PLR, NLR, MLR, and BLR were further elevated while ELR was lowered during exacerbation. PLR, NLR, and MLR were all positively correlated with hospital LOS as well as CRP. In contrast, ELR was negatively correlated with hospital LOS as well as CRP. Elevated PLR, NLR, and MLR were all associated with more serious airflow limitation in AECOPD. Elevated PLR, NLR, and MLR were all associated with increased in-hospital mortality while Elevated ELR was associated with decreased in-hospital mortality. Binary logistic regression analysis showed that smoking history, FEV1% predicted, pneumonia, pulmonary heart disease (PHD), uric acid (UA), albumin, and MLR were significant independent predictors for in-hospital mortality. These predictors along with ELR were used to construct a nomogram predicting in-hospital mortality in AECOPD. The nomogram had a C-index of 0.850 (95% CI: 0.799–0.901), and its good predictive value and clinical applicability were summary further demonstrated. In summary, PLR, NLR, MLR, and ELR served as biomarkers in patients with AECOPD.