Blood Neutrophil to Lymphocyte ratio as a predicator of outcome of acute exacerbation of COPD

Objective: To look into the relationship of neutrophil-to-lymphocyte ratio with outcomes in patients presenting with acute exacerbation of COPD. Methodology: This cross-sectional study was conducted at the Department of Medicine, Pakistan Atomic Energy Commission (PAEC) Hospital, Islamabad, over three months. A total of 105 adult patients presenting with acute exacerbation of COPD were enrolled in the study. Patients with significant comorbidities, concurrent infections, or immunocompromised status were excluded. The study investigated clinical outcomes such as mortality, ventilatory support, ICU transfer, and hospital stay. The data were analyzed using SPSS version 20. Results: Elevated NLR was significantly associated with increased systemic inflammation, longer smoking and disease duration, prolonged hospital stay, higher need for ventilatory support, and increased early mortality. Multivariable analysis confirmed elevated NLR as an independent predictor of ventilator requirement and mortality. Conclusion: NLR is a reliable, inexpensive, and readily available biomarker that correlates with disease severity and adverse outcomes in AECOPD and may aid early risk stratification and management decisions. Keywords: Chronic obstructive; Lymphocytes; Mortality; Neutrophils; Pulmonary disease.