The refined ABCD assessment and non-costly laboratory parameters are outcome predictors in acute exacerbation of COPD

Esmaeel, Hend M.; Ahmed, Heba A.

doi:10.1016/j.ejcdt.2017.06.004

Cited by 5 publications

(18 citation statements)

References 10 publications

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“…Of them, 926 were excluded because they were either duplicates or irrelevant. Following a full-text review of the remaining 18 articles, a further 3 were excluded because they did not fulfill the inclusion criteria, leaving 15 articles for final analysis ( Figure 1 and Table 1 ) [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. In all studies, the NLR was assessed within the first 24–48 h of admission.…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies (seventeen patient groups) of 10,038 AECOPD patients (57% males, mean age 74 years) reported associations between the NLR and adverse outcomes, expressed as ORs by multivariate logistic regression analysis. The adverse outcomes studied included mortality (nine studies) [ 33 , 34 , 35 , 36 , 37 , 38 , 40 , 43 , 45 ], transfer to ICU (one study) [ 36 ], length of hospital stay (one study) [ 46 ], invasive mechanical ventilation (IMV) (one study) [ 20 ], non-invasive mechanical ventilation failure (NIMVF) (one study) [ 44 ], pulmonary hypertension (one study) [ 39 ], and composite endpoints (two studies: ICU admission or death; one study: ICU admission, IMV, or death) [ 32 , 41 , 42 ]. Seven studies investigated in-hospital mortality [ 32 , 34 , 35 , 38 , 40 , 41 , 42 ], three 28-day mortality [ 36 , 43 , 45 ], and two 90-day mortality [ 33 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…The adverse outcomes studied included mortality (nine studies) [ 33 , 34 , 35 , 36 , 37 , 38 , 40 , 43 , 45 ], transfer to ICU (one study) [ 36 ], length of hospital stay (one study) [ 46 ], invasive mechanical ventilation (IMV) (one study) [ 20 ], non-invasive mechanical ventilation failure (NIMVF) (one study) [ 44 ], pulmonary hypertension (one study) [ 39 ], and composite endpoints (two studies: ICU admission or death; one study: ICU admission, IMV, or death) [ 32 , 41 , 42 ]. Seven studies investigated in-hospital mortality [ 32 , 34 , 35 , 38 , 40 , 41 , 42 ], three 28-day mortality [ 36 , 43 , 45 ], and two 90-day mortality [ 33 , 37 ]. Eight studies were conducted in China [ 36 , 37 , 39 , 42 , 43 , 44 , 45 , 46 ], two in Iran [ 34 , 40 ], two in Turkey [ 35 , 38 ], one in Egypt [ 32 ], one in Australia [ 33 ], and one in Colombia [ 41 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies investigated in-hospital mortality [ 32 , 34 , 35 , 38 , 40 , 41 , 42 ], three 28-day mortality [ 36 , 43 , 45 ], and two 90-day mortality [ 33 , 37 ]. Eight studies were conducted in China [ 36 , 37 , 39 , 42 , 43 , 44 , 45 , 46 ], two in Iran [ 34 , 40 ], two in Turkey [ 35 , 38 ], one in Egypt [ 32 ], one in Australia [ 33 ], and one in Colombia [ 41 ] ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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A Comprehensive Systematic Review and Meta-Analysis of the Association between the Neutrophil-to-Lymphocyte Ratio and Adverse Outcomes in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zinellu

Pau

et al. 2022

JCM

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The neutrophil-to-lymphocyte ratio (NLR) predicts adverse outcomes in stable chronic obstructive pulmonary disease (COPD); however, its prognostic role in acute exacerbations (AECOPD) is less clear. We conducted a systematic review and meta-analysis of the association between the NLR on admission and adverse outcomes (mortality, need for mechanical ventilation, transfer to the intensive care unit, length of stay, pulmonary hypertension, or their combination) in AECOPD by searching PubMed, Web of Science, and Scopus from inception to April 2022. Risk of bias and certainty of evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the Grades of Recommendation, Assessment, Development, and Evaluation, respectively. In 15 studies (n = 10,038 patients), the NLR was significantly associated with the risk of adverse outcomes (odds ratio = 1.054, 95% CI 1.016 to 1.093, p = 0.005; low certainty of evidence; standard mean difference = 0.82, 95% CI 0.57 to 1.06, p < 0.001; high certainty of evidence). Pooled sensitivity, specificity, and area under the curve were 0.71 (95% CI 0.64 to 0.77), 0.73 (95% CI 0.65 to 0.80), and 0.78 (95% CI 0.74 to 0.81), respectively. In our study, the NLR on admission was significantly associated with adverse outcomes in AECOPD patients, suggesting the potential utility of this biomarker for early risk stratification and management in this group.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

A Comprehensive Systematic Review and Meta-Analysis of the Association between the Neutrophil-to-Lymphocyte Ratio and Adverse Outcomes in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Zinellu

Pau

et al. 2022

JCM

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“…Neutrophil to lymphocyte ratio had already been investigated in many inflammatory diseases, predominantly in malignant diseases [8][9][10][11][12][13] and in compliance with smoking status [14]. It was also recognized as a useful marker for the assessment of FEV 1 -based COPD severity [15,16]. Moreover, it was observed that symptoms and quality of life deteriorated with the increase of NLR [17].…”

Section: Introductionmentioning

confidence: 99%

Influence of disease severity, smoking status and therapy regimes on leukocyte subsets and their ratios in stable chronic obstructive pulmonary disease

et al. 2020

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IntroductionBlood cells are involved in systemic inflammation in chronic obstructive pulmonary disease (COPD). We aimed to assess differences in leukocyte subsets and their ratios between COPD patients and healthy individuals as well as their association with disease severity, smoking status and therapy in COPD.Material and methodsOne hundred and nine patients in the stable phase of COPD and 95 controls participated in the study. After blood sampling, white blood cells (WBC), neutrophils (NEUTRO), monocytes (MO), lymphocytes (LY) and basophils (BA) were determined on a Sysmex XN-1000 analyser, and ratios were calculated afterwards.ResultsWhite blood cells, NEUTRO, MO and BA were higher in COPD patients than in controls. Also, COPD patients had increased neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR), monocyte to lymphocyte ratio (MLR), basophil to lymphocyte ratio (BLR), basophil to monocyte ratio (BMR) and monocyte/granulocyte to lymphocyte ratio (M/GLR). Smoking has an impact on leukocyte counts, with BA, BLR and BMR being higher in COPD smokers vs. ex-smokers. Patients with very severe COPD were distinguished from moderate COPD by NLR, dNLR and M/GLR. In addition, those parameters were associated with lung function and dyspnoea, and NLR and dNLR also with multicomponent COPD indices BODCAT and DOSE. Great potential of dNLR, NLR and M/GLR in identifying COPD patients was observed regarding their odds ratios (OR) of 5.07, 2.86, 2.60, respectively (p < 0.001). Common COPD therapy did not affect any of the parameters investigated.ConclusionsLeukocyte subsets and their ratios could be implemented in COPD assessment, especially in evaluating disease severity and prediction.

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Clinical significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute exacerbations of COPD: present and future

Zinellu

Zinellu²,

Mangoni³

et al. 2022

Eur Respir Rev

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Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a leading cause of hospitalisation and death in COPD patients. In addition to the identification of better strategies to prevent AECOPD, there is an intense focus on discovering novel markers of disease severity that enhance risk stratification on hospital admission for the targeted institution of aggressiveversussupportive treatments. In the quest for such biomarkers, an increasing body of evidence suggests that specific indexes derived from routine complete blood counts,i.e.the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), can significantly predict adverse outcomes in AECOPD. This narrative review discusses the current evidence regarding the association between the NLR and the PLR on admission and several clinical end-points (need for invasive ventilation, noninvasive mechanical ventilation failure, admission to an intensive care unit, pulmonary hypertension, length of hospitalisation, and mortality) in AECOPD. Future research directions and potential clinical applications of these haematological indexes in this patient group are also discussed.

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The refined ABCD assessment and non-costly laboratory parameters are outcome predictors in acute exacerbation of COPD

Cited by 5 publications

References 10 publications

A Comprehensive Systematic Review and Meta-Analysis of the Association between the Neutrophil-to-Lymphocyte Ratio and Adverse Outcomes in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

A Comprehensive Systematic Review and Meta-Analysis of the Association between the Neutrophil-to-Lymphocyte Ratio and Adverse Outcomes in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Influence of disease severity, smoking status and therapy regimes on leukocyte subsets and their ratios in stable chronic obstructive pulmonary disease

Clinical significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute exacerbations of COPD: present and future

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