Evaluation of Role of Neutrophil-To-Lymphocyte Ratio as a Predictor of Outcome in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Background: This study evaluate the role of the Neutrophil to Lymphocyte Ratio (NLR) in predicting clinical outcomes for patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD)

Materials and Methods: 80 patients diagnosed with AECOPD from Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation between September 2025 and March 2026 were included in this cross-sectional observational study. Patients >40 years old with a confirmed history of COPD and presenting with an acute exacerbation were included in the study. NLR was calculated from complete blood count parameters. Clinical outcomes studied were ICU admission, type of ventilatory support, duration of hospital stay, and discharge status.

Results: Of the 80 patients, 78 had improvement their clinical condition and 2 died. The mean NLR was significantly higher for ICU patients (11.63) than ward patients (4.39) (p < 0.001). The mean NLR for patients requiring invasive ventilation was the highest (24.72), while the non-invasive ventilation was (9.36) and oxygen therapy was (5.24) (p < 0.00001). Patients with a hospital stay >10 days had an elevated NLR (19.88). Non-survivors had a much higher NLR (30.98) than survivors (8.65) (p < 0.001).

Conclusion: The results demonstrate that elevated NLR is strongly correlated with worse disease severity and outcomes, including ICU admission, need for ventilatory support, prolonged hospital duration, and mortality for patients with AECOPD. Therefore, NLR can potentially serve as a rapid, easy, and inexpensive prognostic biomarker in the clinical practice for patients with AECOPD.