| Title |
Eosinophilic and non-eosinophilic COPD patients with chronic respiratory failure: neutrophil-to-lymphocyte ratio as an exacerbation marker
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, November 2017
|
| DOI | 10.2147/copd.s147261 |
| Pubmed ID | |
| Authors |
Eylem Acartürk Tunçay, Zuhal Karakurt, Emine Aksoy, Cuneyt Saltürk, Sinem Gungor, Nezihe Ciftaslan, İlim Irmak, Dilek Yavuz, Birsen Ocakli, Nalan Adıgüzel |
| Abstract |
Increased dyspnea, sputum volume, and purulence are subjective symptoms in COPD patients. To diagnose COPD exacerbations with chronic respiratory failure (CRF) and to assess the requirement for antibiotic treatment, physicians require more objective criteria. We aimed to investigate whether neutrophil-to-lymphocyte ratio (NLR) can be used as an infectious exacerbation marker in COPD patients with CRF. This retrospective cross-sectional study was performed in the intensive care outpatient clinic of a tertiary training hospital between 2014 and 2015. Patients admitted with CRF due to COPD and who had complete blood count (CBC) results were enrolled. CBC results and C-reactive protein (CRP) levels were obtained from the hospital online database. The "modified exacerbation model (MEM)" was defined as follows: exacerbation A, leukocytes ≥12,000/mm3, CRP >10 mg/dL; exacerbation B, leukocytes ≥10,000/mm3, CRP >10 mg/dL; exacerbation C, leukocytes ≥10,000/mm3, CRP >8 mg/dL; exacerbation D, leukocytes ≥10,000/mm3, CRP >5 mg/dL. The cutoff value of NLR was defined for each model. Patients were split into two groups based on the NLR cutoff value according to the "NLR exacerbation model" and further subgrouped according to peripheral eosinophil percentage (eosinophils ≥2% and <2%) and compared with the MEM. A total of 1,066 COPD patients (430 females, 40.3%), with a mean age of 66±13 years, were included. A NLR cutoff value of 3.54 (NLR ≥3.54, n=366, 34%) showed the highest sensitivity and specificity for model A (78%, 69%), model B (63%, 71%), model C (61%, 72%), and model D (58%, 72%). Peripheral eosinophilia (PE ≥2%) was present in 48 patients (4.5%). The ratio of patients with PE <2% in the NLR ≥3.54 group was significantly higher in the MEM (P<0.001). The NLR presents an attractive option as an exacerbation marker in COPD patients with CRF due to its simplicity and cost-effectiveness. In COPD patients with CRF, where the NLR is ≥3.54, PE levels are <2%, and subjective symptoms are present, antibiotic treatment should be considered. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 66 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 9 | 14% |
| Other | 7 | 11% |
| Student > Doctoral Student | 7 | 11% |
| Student > Postgraduate | 5 | 8% |
| Researcher | 4 | 6% |
| Other | 13 | 20% |
| Unknown | 21 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 30% |
| Biochemistry, Genetics and Molecular Biology | 4 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 5% |
| Immunology and Microbiology | 3 | 5% |
| Nursing and Health Professions | 3 | 5% |
| Other | 6 | 9% |
| Unknown | 27 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 July 2018.
All research outputs
#15,879,822
of 25,584,565 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#1,414
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Outputs of similar age
#188,043
of 341,375 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#37
of 73 outputs
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