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, while at 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