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- Title
Predictive role of neutrophil‐percentage‐to‐albumin, neutrophil‐to‐lymphocyte and eosinophil‐to‐lymphocyte ratios for mortality in patients with COPD: Evidence from NHANES 2011–2018.
- Authors
Lan, Chou‐Chin; Su, Wen‐Lin; Yang, Mei‐Chen; Chen, Sin‐Yi; Wu, Yao‐Kuang
- Abstract
Background and Objective: This study evaluated the predictive roles of hematologic inflammatory biomarkers including neutrophil‐percentage‐to‐albumin ratio (NPAR), neutrophil‐to‐lymphocyte ratio (NLR) and eosinophil‐to‐lymphocyte ratio (ELR) for mortality in community‐dwelling individuals with chronic obstructive pulmonary disease (COPD). Methods: This longitudinal study extracted data of adults 40–79 years who had physician‐diagnosed COPD from the United States (US) National Health and Nutrition Examination Survey (NHANES) 1999–2018. Cox regressions determined the associations between NPAR, NLR, ELR and their components, with all‐cause mortality, cardiovascular disease (CVD) mortality and mortality from chronic lower respiratory disease (CLRD). Receiver operating characteristic (ROC) curve analysis estimated the predictive performances of these biomarkers for 5‐year all‐cause mortality. Results: Data of 1158 subjects were analysed. After adjustment, higher NPAR was significantly associated with increased all‐cause and CVD mortality, and mortality from CLRD (adjusted hazard ratio [aHR] = 1.14, 1.15 and 1.16). Higher NLR was associated with an increased all‐cause and CVD mortality (aHR = 1.16 and 1.29). Higher neutrophil was associated with increased all‐cause mortality and mortality from CLRD (aHR = 1.13 and 1.34). Albumin was associated with decreased all‐cause and CVD mortality (aHR = 0.91 and 0.86). ELR, eosinophil or lymphocyte was not significantly associated with either mortality outcomes. Adjusted AUC of NPAR and NLR in predicting 5‐year all‐cause mortality were 0.808 (95% CI: 0.722–0.845) and 0.799 (95% CI: 0.763–0.835), respectively. Conclusion: In community‐dwelling US adults with COPD, increased NPAR and NLR are associated with mortality risks. NPAR outperforms the other hematologic inflammatory biomarkers in predicting 5‐year all‐cause mortality. Easy‐to‐use accurate predictors of chronic obstructive pulmonary disease (COPD) prognosis are important. Data from community‐dwelling adults with COPD in the United States were analysed to investigate associations and predictive values of several biomarkers derived from routine blood samples. Neutrophil‐percentage‐to‐albumin (NPAR) ratio appeared to be the best indicator of mortality in these patients. See relatededitorial
- Subjects
UNITED States; NEUTROPHIL lymphocyte ratio; CARDIOVASCULAR diseases; HEALTH &; Nutrition Examination Survey; CHRONIC obstructive pulmonary disease; RECEIVER operating characteristic curves
- Publication
Respirology, 2023, Vol 28, Issue 12, p1136
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.14589