Background

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause for hospital admission and COPD(chronic obstructive pulmonary disease) related morbidity. This encouraged clinicians to search for useful and easy inflammatory biomarkers for recognizing AECOPD.

Objective

To evaluate the role of the neutrophil/lymphocyte ratio (NLR) and C-reactive protein (CRP) in COPD patients for recognition of an acute exacerbation requiring hospital admission.

Patients and Methods

A prospective study included 100 hospitalized AECOPD patients, 88 stable COPD, and 80 sex and age matched healthy subjects. NLR and CRP were measured twice for each patient, first at hospital admission and the second was 3 months later as follow up. NLR was calculated from the complete blood count (CBC).

Results

The total white blood cell count (WBCs), Neutrophils, and NLR ratio were significantly higher in AECOPD group (P< 0.05 for each). CRP and forced expiratory volume in first second (FEV1% predicted) showed a significant correlation with NLR (P˂ 0.05). At cut off value˃ 3.26 for NLR the sensitivity and specificity were 84.7% and 78.0% respectively, whileat cut off value> 4.11 for CRP the sensitivity and specificity were 77.9 % and 68.2% respectively for the prediction of AECOPD.

Conclusion

Elevated NLR can be used as a marker similar to WBCs and CRP, in the detection of increased inflammation in hospitalized acutely exacerbated COPD patients.