Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease

Yuer Li,1 Shaobo Ge,1 Jin Liu,1 Rui Li,1 Rui Zhang,1 Juan Wang,2 Jianli Pan,3 Qiuhong Zhang,1 Jie Zhang,1 Ming Zhang1 1Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Ultraso...

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Main Authors: Li Y, Ge S, Liu J, Li R, Zhang R, Wang J, Pan J, Zhang Q, Zhang J, Zhang M
Format: Article
Language:English
Published: Dove Medical Press 2025-01-01
Series:International Journal of COPD
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Online Access:https://www.dovepress.com/peripheral-blood-nmlr-can-predict-5-year-all-cause-mortality-in-patien-peer-reviewed-fulltext-article-COPD
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author Li Y
Ge S
Liu J
Li R
Zhang R
Wang J
Pan J
Zhang Q
Zhang J
Zhang M
author_facet Li Y
Ge S
Liu J
Li R
Zhang R
Wang J
Pan J
Zhang Q
Zhang J
Zhang M
author_sort Li Y
collection DOAJ
description Yuer Li,1 Shaobo Ge,1 Jin Liu,1 Rui Li,1 Rui Zhang,1 Juan Wang,2 Jianli Pan,3 Qiuhong Zhang,1 Jie Zhang,1 Ming Zhang1 1Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Ultrasound, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 3Department of Special Need, Xi’an Children’s Hospital, Xi’an, Shaanxi, People’s Republic of ChinaCorrespondence: Ming Zhang, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University, No. 157 West Fifth Road, Xi’an, Shaanxi, 710004, People’s Republic of China, Email zhangmingdr@163.comBackground: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammation. The peripheral blood (neutrophil + monocyte)/lymphocyte ratio (NMLR) can predict the clinical outcomes of several inflammatory diseases. However, its prognostic value in COPD remains unknown.Methods: This retrospective study included 870 patients with COPD due to acute exacerbation, and the 5-year all-cause mortality of these patients was recorded. The Kaplan-Meier method was used to compare the mortality risk of these patients according to their NMLR value. Multivariable COX hazard regression and restricted cubic spline model were used to assess the relationship between the NMLR and 5-year all-cause mortality of patients with COPD.Results: The NMLR values of non-surviving patients with COPD were significantly increased compared to the survivors [3.88 (2.53– 7.17) vs 2.95 (2.08– 4.89), P=0.000]. The area under the NMLR receiver operating characteristic curve for predicting the 5-year all-cause mortality of COPD patients was 0.63. Kaplan-Meier survival curves showed that the 5-year all-cause mortality of COPD patients was significantly increased when the admission peripheral blood NMLR was ≥ 5.90 (27.3% vs 12.4%, P=0.000). The COX regression model showed that NMLR was an independent predictor of 5-year all-cause mortality in COPD patients (hazard ratio=1.84, 95% confidence interval: 1.28– 2.64, P=0.001). Moreover, the restricted cubic spline model showed a non-linear relationship between NMLR and COPD death risk (Pnon-linear < 0.05).Conclusion: The admission peripheral blood NMLR is a significant predictor of 5-year all-cause mortality in patients with COPD, and high NMLR values may indicate a poor clinical prognosis.Keywords: chronic obstructive pulmonary disease, neutrophil, monocyte, lymphocyte, inflammation, prognosis
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series International Journal of COPD
spelling doaj-art-b481fcf1943a4c5faa57ae5032b7a7412025-01-09T16:58:35ZengDove Medical PressInternational Journal of COPD1178-20052025-01-01Volume 209510599090Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary DiseaseLi YGe SLiu JLi RZhang RWang JPan JZhang QZhang JZhang MYuer Li,1 Shaobo Ge,1 Jin Liu,1 Rui Li,1 Rui Zhang,1 Juan Wang,2 Jianli Pan,3 Qiuhong Zhang,1 Jie Zhang,1 Ming Zhang1 1Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Ultrasound, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 3Department of Special Need, Xi’an Children’s Hospital, Xi’an, Shaanxi, People’s Republic of ChinaCorrespondence: Ming Zhang, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Xi’an Jiaotong University, No. 157 West Fifth Road, Xi’an, Shaanxi, 710004, People’s Republic of China, Email zhangmingdr@163.comBackground: Chronic obstructive pulmonary disease (COPD) is characterized by pulmonary and systemic inflammation. The peripheral blood (neutrophil + monocyte)/lymphocyte ratio (NMLR) can predict the clinical outcomes of several inflammatory diseases. However, its prognostic value in COPD remains unknown.Methods: This retrospective study included 870 patients with COPD due to acute exacerbation, and the 5-year all-cause mortality of these patients was recorded. The Kaplan-Meier method was used to compare the mortality risk of these patients according to their NMLR value. Multivariable COX hazard regression and restricted cubic spline model were used to assess the relationship between the NMLR and 5-year all-cause mortality of patients with COPD.Results: The NMLR values of non-surviving patients with COPD were significantly increased compared to the survivors [3.88 (2.53– 7.17) vs 2.95 (2.08– 4.89), P=0.000]. The area under the NMLR receiver operating characteristic curve for predicting the 5-year all-cause mortality of COPD patients was 0.63. Kaplan-Meier survival curves showed that the 5-year all-cause mortality of COPD patients was significantly increased when the admission peripheral blood NMLR was ≥ 5.90 (27.3% vs 12.4%, P=0.000). The COX regression model showed that NMLR was an independent predictor of 5-year all-cause mortality in COPD patients (hazard ratio=1.84, 95% confidence interval: 1.28– 2.64, P=0.001). Moreover, the restricted cubic spline model showed a non-linear relationship between NMLR and COPD death risk (Pnon-linear < 0.05).Conclusion: The admission peripheral blood NMLR is a significant predictor of 5-year all-cause mortality in patients with COPD, and high NMLR values may indicate a poor clinical prognosis.Keywords: chronic obstructive pulmonary disease, neutrophil, monocyte, lymphocyte, inflammation, prognosishttps://www.dovepress.com/peripheral-blood-nmlr-can-predict-5-year-all-cause-mortality-in-patien-peer-reviewed-fulltext-article-COPDchronic obstructive pulmonary diseaseneutrophilmonocytelymphocyteinflammationprognosis
spellingShingle Li Y
Ge S
Liu J
Li R
Zhang R
Wang J
Pan J
Zhang Q
Zhang J
Zhang M
Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease
International Journal of COPD
chronic obstructive pulmonary disease
neutrophil
monocyte
lymphocyte
inflammation
prognosis
title Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease
title_full Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease
title_fullStr Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease
title_full_unstemmed Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease
title_short Peripheral Blood NMLR Can Predict 5-Year All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease
title_sort peripheral blood nmlr can predict 5 year all cause mortality in patients with chronic obstructive pulmonary disease
topic chronic obstructive pulmonary disease
neutrophil
monocyte
lymphocyte
inflammation
prognosis
url https://www.dovepress.com/peripheral-blood-nmlr-can-predict-5-year-all-cause-mortality-in-patien-peer-reviewed-fulltext-article-COPD
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