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The Neutrophil Lymphocyte Ratio as a Predictor of Acute Exacerbations Among Patients with COPD in Uganda

Alupo, Patricia; Katagira, Winceslaus; Mukunya, David; Okimat, Paul; Tejwani, Vickram; Kayongo, Alex; Nalunjogi, Joanitah; ... Siddharthan, Trishul; + view all (2024) The Neutrophil Lymphocyte Ratio as a Predictor of Acute Exacerbations Among Patients with COPD in Uganda. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation , 11 (2) pp. 187-195. 10.15326/jcopdf.2023.0443. Green open access

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Abstract

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is an inexpensive biomarker that potentially predicts acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). We evaluated the association of baseline NLR and respiratory hospitalization risk within one year among chronic obstructive pulmonary disease (COPD) patients in Uganda, a low- and middle-income country. METHODS: A total of 312 COPD patients were followed for one year. Clinical characteristics and exacerbation rates were collected. Poisson regression with robust variance estimators was used to measure the association between NLR and hospital admissions due to COPD exacerbations. Receiver-operator characteristic (ROC) curves and the area under the curve were used to assess the ability of NLR to predict AECOPDs. RESULTS: The median (Q 1, Q 3) age was 64 years (53, 71). Females comprised 50.96% (n=159) of the cohort, and 71.2% (n=222) of participants had moderate or severe COPD. A total of 9.9% (n=31) of participants experienced a COPD exacerbation during the period of follow-up. At baseline, the median (Q 1, Q 3) NLR ratio among participants who experienced an exacerbation was 1.46 (0.92, 2.33) compared to 1.03 (0.72,1.42) among those who did not experience one during the follow-up period (p=0.002). Using Youden and Liu’s methods, the optimal NLR cutoff for predicting COPD exacerbation was 1.17. This cutoff resulted in a ROC curve area of 0.64 (95% confidence interval: 0.56, 0.73). CONCLUSION: The NLR could be used as a risk predictor, in low- and middle-income countries, for hospital admissions due to COPD exacerbations. A cutoff of 1.17 was an independent predictor of hospitalization due to acute exacerbations of COPD within one year.

Type: Article
Title: The Neutrophil Lymphocyte Ratio as a Predictor of Acute Exacerbations Among Patients with COPD in Uganda
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.15326/jcopdf.2023.0443
Publisher version: http://dx.doi.org/10.15326/jcopdf.2023.0443
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: COPD; exacerbations; acute exacerbations of COPD; biomarkers; neutrophil-to-lymphocyte ratio
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10186234
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