Mohammad HOSSEİN, Shaghayegh RAHIMIRAD, Mohammad REZA, Farid RASHIDI, Mohammad Hossein RAHIMIRAD

Kronik obstrüktif akciğer hastalığı alevlenme olgularında başvuru nötrofil lenfosit oranı ile prognoz arasındaki ilişki

Kronik obstrüktif akciğer hastalığı alevlenme olgularında başvuru nötrofil lenfosit oranı ile prognoz arasındaki ilişkiGiriş: Nötrofil lenfosit (NLO), hesaplanmış nötrofil lenfosit (h-NLO), platelet lenfosit (PLO) ve lenfosit monosit (LMO) oranlarının çeşitli hastalıklarda prognoz tahmininde önemli olduğu gösterilmiştir. Bildiğimiz kadarı ile bu oranların kronik obstrüktif akciğer hastalığı (KOAH) alevlenmesi olgularında incelendiği çalışma bulunmamaktadır. Bu çalışmanın amacı bu parametrelerin KOAH alevlenme nedeni ile hastanede yatan olguların hastane yatış mortalitesini tahminindeki faydasını araştırmaktır. Hastalar ve Metod: Bu çalışma İran'daki Tebriz ve Urmia şehirlerindeki iki hastanede yapılan retrospektif bir çalışmadır. KOAH alevlenme tanılı olguları başvuru hemogram sonuçlarından NLO, PLO, LMO ve h-NLO hesaplandı. Hastanede yatarken ölen ve şifa ile taburcu olan olguların sonuçları karşılaştırıldı. Bulgular: Toplam 315 olgunun 70 (%22.2)'i hastanede öldü. Kalan 245 (%77.8) olgu şifa ile taburcu edildi. NLO >= 4 olanlarda NLO < 4 olanlara göre mortalite daha yüksekti (%24'e karşın %9.5 p< 0.001). Multivariate analizlere göre NLO (p= 0.001) hastane mortalitesinin bağımsız göstergelerinden birisiydi. NLO hem univariate (OR= 3.80) hem multivariate (OR= 3.50) analizlerde en yüksek odds ratioya (OR) sahipti. NLO için eğri altında kalan alan (ROC) 0.72 (%95 CI: 0.62-0.81; p< 0.001) idi. PLO ve LMO ile hastane mortalitesi arasında istatistiksel anlamlı ilişki saptanmadı. Sonuç: İlk kez bu çalışmada KOAH alevlenme ile başvuran hastalarda hastane mortalitesi ile NLO arasında istatistiksel anlamlı ilişki olduğu gösterildi.

Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease

Introduction: The prognostic significance of neutrophil-to-lymphocyte ratio (NLR), derived-neutrophil-to-lymphocyte ratio (d-NLR),platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been shown in many diseases. To the best of ourknowledge, there is no published report evaluation of those parameters in acute exacerbation of chronic obstructive pulmonarydisease (AECOPD). The aims of this study are to evaluate the parameters in predicting in-hospital mortality in patients with AECOPD.Materials and Methods: This is a retrospective study in two referral hospitals in Tabriz and Urmia, Iran. NLRs, PLR, LMR, and d-NLRwere calculated from the admission day complete blood count of patients with AECOPD. Comparison was made between patientswho died in hospital and those discharged alive.Results: Of 315 patients, 70 (22.2%) died in the hospital and 245 (77.8%) were discharged alive. The mortality rate was higher inpatients with NLR >= 4 than with NLR < 4 (24% vs. 9.5% p value < 0.001). Multivariate analysis revealed NLR (p= 0.001) wereindependently associated with in-hospital mortality. NLR had the highest odds ratio for death both in univariate (OR= 3.80) andmultivariate (OR= 3.50) analyses. The area under the receiver-operating characteristic curve for NLR in predicting in-hospital deathwas 0.72 (95% CI: 0.62-0.81; p< 0.001). PLR and LMR did notshow significant relation to in-hospital death in AECOPD.Conclusion: This study shows for the first time that higher NLR ispositively associated with in-hospital mortality in AECOPD.

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