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Acet-Öztürk NA, Aydin-Güçlü Ö, Yildiz MN, Demirdöğen E, Görek Dilektaşli A, Coşkun F, Uzaslan E, Ursavaş A, Karadağ M. Comparison of BAP65, DECAF, PEARL, and MEWS Scores in Predicting Respiratory Support Need in Hospitalized Exacerbation of Chronic Obstructive Lung Disease Patients. Med Princ Pract 2024:1-9. [PMID: 38626747 DOI: 10.1159/000538812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/09/2024] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVE Prognostic models aid clinical practice with decision-making on treatment and hospitalization in exacerbation of chronic obstructive lung disease (ECOPD). Although there are many studies with prognostic models, diagnostic accuracy is variable within and between models. SUBJECTS AND METHODS We compared the prognostic performance of the BAP65 score, DECAF score, PEARL score, and modified early warning score (MEWS) in hospitalized patients with ECOPD, to estimate ventilatory support need. RESULTS This cross-sectional study consisted of 139 patients. Patients in need of noninvasive or invasive mechanical ventilation support are grouped as ventilatory support groups (n = 54). Comparison between receiver operating characteristic curves revealed that the DECAF score is significantly superior to the PEARL score (p = 0.04) in discriminating patients in need of ventilatory support. DECAF score with a cutoff value of 1 presented the highest sensitivity and BAP65 score with a cutoff value of 2 presented the highest specificity in predicting ventilatory support need. Multivariable analysis revealed that gender played a significant role in COPD exacerbation outcome, and arterial pCO2 and RDW measurements were also predictors of ventilatory support need. Within severity indexes, only the DECAF score was independently associated with the outcome. One-point increase in DECAF score created a 1.43 times higher risk of ventilatory support need. All severity indexes showed a correlation with age, comorbidity index, and dyspnea. BAP65 and DECAF scores also showed a correlation with length of stay. CONCLUSION Objective and practical classifications are needed by clinicians to assess prognosis and initiate treatment accordingly. DECAF score is a strong candidate among severity indexes.
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Affiliation(s)
| | - Özge Aydin-Güçlü
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Merve Nur Yildiz
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ezgi Demirdöğen
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | | | - Funda Coşkun
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Esra Uzaslan
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ahmet Ursavaş
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Karadağ
- Department of Pulmonology, Uludağ University Faculty of Medicine, Bursa, Turkey
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Hu HS, Wang Z, Jian LY, Zhao LM, Liu XD. Optimizing inhaled corticosteroid use in patients with chronic obstructive pulmonary disease: assessing blood eosinophils, neutrophil-to-lymphocyte ratio, and mortality outcomes in US adults. Front Immunol 2023; 14:1230766. [PMID: 38035096 PMCID: PMC10684949 DOI: 10.3389/fimmu.2023.1230766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Objective Accurate biomarkers for evaluating mortality rates in patients with chronic obstructive pulmonary disease (COPD) remain scarce. This study aimed to explore the relationships between mortality rates in patients with COPD and blood eosinophil counts, neutrophil counts, and lymphocyte counts, along with the neutrophil-to-lymphocyte ratio (NLR). Additionally, we sought to identify the optimal response values for these biomarkers when utilizing inhaled corticosteroids (ICS). Methods Utilizing a nationally representative, multistage cross-sectional design and mortality correlation study, we analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 involving US adults aged 40 years or older with COPD. The primary endpoint was all-cause mortality, with Kaplan-Meier survival curves and restricted cubic splines applied to illustrate the relationship between leukocyte-based inflammatory markers and mortality. The analysis was conducted in 2023. Results Our analysis included 1,715 COPD participants, representing 6,976,232 non-institutionalized US residents [weighted mean age (SE), 62.09 (0.28) years; range, 40-85 years]. Among the participants, men constituted 50.8% of the population, and the weighted mean follow-up duration was 84.9 months. In the ICS use group, the weighted proportion of participants over 70 years old was significantly higher compared with the non-ICS use group (31.39% vs 25.52%, p < 0.0001). The adjusted hazard ratios for all-cause mortality related to neutrophil counts, lymphocyte counts, and NLR were 1.10 [95% confidence interval (CI), 1.04-1.16, p < 0.001], 0.83 (95% CI, 0.71-0.98; p = 0.03), and 1.10 (95% CI, 1.05-1.15; p < 0.0001), respectively. Optimal ICS response was linked with higher levels of eosinophil count (≥240 cells/μL), neutrophil count (≥3,800 cells/μL), NLR (≥4.79), and lower levels of lymphocyte count (<2,400 cells/μL). Conclusion Adjusted baseline neutrophil, lymphocyte counts, and NLR serve as independent risk factors for all-cause mortality in patients with COPD. Further, ICS application appears to mitigate mortality risk, particularly when NLR levels reach 4.79 or higher, underlining the importance of ICS in COPD management.
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Affiliation(s)
- Han-Shuo Hu
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
- Department of The Second Clinical Pharmacy, School of Pharmacy, China Medical University, Shenyang, China
| | - Zhuo Wang
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
- Department of The Second Clinical Pharmacy, School of Pharmacy, China Medical University, Shenyang, China
| | - Ling-Yan Jian
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
- Department of The Second Clinical Pharmacy, School of Pharmacy, China Medical University, Shenyang, China
| | - Li-Mei Zhao
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
- Department of The Second Clinical Pharmacy, School of Pharmacy, China Medical University, Shenyang, China
| | - Xiao-Dong Liu
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
- Department of The Second Clinical Pharmacy, School of Pharmacy, China Medical University, Shenyang, China
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Martínez-Gestoso S, García-Sanz MT, Carreira JM, Nieto-Fontarigo JJ, Calvo-Álvarez U, Doval-Oubiña L, Camba-Matos S, Peleteiro-Pedraza L, Roibás-Veiga I, González-Barcala FJ. Prognostic Usefulness of Basic Analytical Data in Chronic Obstructive Pulmonary Disease Exacerbation. OPEN RESPIRATORY ARCHIVES 2023; 5:100271. [PMID: 37818452 PMCID: PMC10560836 DOI: 10.1016/j.opresp.2023.100271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/01/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction COPD causes high morbidity and mortality and high health costs. Thus, identifying and analyzing the distinctive and treatable traits seems useful to optimize the management of AEPOC patients. While various biomarkers have been researched, no solid data for systematic use have been made available. Aim Assessing the short-term prognostic usefulness of clinical and analytical parameters available in routine clinical practice in COPD exacerbations. Material and methods Multicenter prospective observational study conducted between 2016 and 2018. Patients admitted for COPD exacerbation who agreed to participate and signed an informed consent form were included. Prolonged stay, in-hospital mortality or early readmission was considered an unfavorable progression. 30-Day mortality was also analyzed. Results 615 patients were included. Mean age was 73.9 years (SD 10.6); 86.2% were male. Progression of 357 patients (58%) was considered unfavorable. Mortality at 1 month from discharge was 6.7%. The multivariate analysis shows a relationship between the CRP/Albumin ratio and unfavorable progression (OR 1.008, 95% CI 1.00; 1.01), as well as increased risk of death at 1 month from discharge with elevated urea (OR 1.01, 95% CI 1.005; 1.02) and troponin T (OR 2.21, 95% CI 1.06; 4.62). Conclusion Elevated CRP/Albumin, urea and TnT are prognostic indicators of poor short-term outcome in patients admitted for COPD exacerbation. Cardiovascular comorbidity and systemic inflammation could explain these findings.
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Affiliation(s)
| | | | | | - Juan-José Nieto-Fontarigo
- Department of Biochemistry and Molecular Biology, Faculty of Biology-Biological Research Centre (CIBUS), University of Santiago de Compostela, Spain
| | - Uxío Calvo-Álvarez
- Respiratory Medicine, University Hospital Complex of Santiago de Compostela, Spain
| | | | - Sandra Camba-Matos
- Emergencies Department Salnés Couny Hospital, Vilagarcía de Arousa, Spain
| | | | | | - Francisco-Javier González-Barcala
- Department of Biochemistry and Molecular Biology, Faculty of Biology-Biological Research Centre (CIBUS), University of Santiago de Compostela, Spain
- Department of Medicine, University of Santiago de Compostela, Spain
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Ji Z, Li X, Lei S, Xu J, Xie Y. A pooled analysis of the risk prediction models for mortality in acute exacerbation of chronic obstructive pulmonary disease. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:707-718. [PMID: 36945821 PMCID: PMC10435958 DOI: 10.1111/crj.13606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE The prognosis for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not optimistic, and severe AECOPD leads to an increased risk of mortality. Prediction models help distinguish between high- and low-risk groups. At present, many prediction models have been established and validated, which need to be systematically reviewed to screen out more suitable models that can be used in the clinic and provide evidence for future research. METHODS We searched PubMed, EMBASE, Cochrane Library and Web of Science databases for studies on risk models for AECOPD mortality from their inception to 10 April 2022. The risk of bias was assessed using the prediction model risk of bias assessment tool (PROBAST). Stata software (version 16) was used to synthesize the C-statistics for each model. RESULTS A total of 37 studies were included. The development of risk prediction models for mortality in patients with AECOPD was described in 26 articles, in which the most common predictors were age (n = 17), dyspnea grade (n = 11), altered mental status (n = 8), pneumonia (n = 6) and blood urea nitrogen (BUN, n = 6). The remaining 11 articles only externally validated existing models. All 37 studies were evaluated at a high risk of bias using PROBAST. We performed a meta-analysis of five models included in 15 studies. DECAF (dyspnoea, eosinopenia, consolidation, acidemia and atrial fibrillation) performed well in predicting in-hospital death [C-statistic = 0.91, 95% confidence interval (CI): 0.83, 0.98] and 90-day death [C-statistic = 0.76, 95% CI: 0.69, 0.82] and CURB-65 (confusion, urea, respiratory rate, blood pressure and age) performed well in predicting 30-day death [C-statistic = 0.74, 95% CI: 0.70, 0.77]. CONCLUSIONS This study provides information on the characteristics, performance and risk of bias of a risk model for AECOPD mortality. This pooled analysis of the present study suggests that the DECAF performs well in predicting in-hospital and 90-day deaths. Yet, external validation in different populations is still needed to prove this performance.
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Affiliation(s)
- Zile Ji
- Department of Respiratory DiseasesThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouChina
| | - Xuanlin Li
- Department of Respiratory DiseasesThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouChina
| | - Siyuan Lei
- Department of Respiratory DiseasesThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouChina
| | - Jiaxin Xu
- Department of Respiratory DiseasesThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouChina
| | - Yang Xie
- Department of Respiratory DiseasesThe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouChina
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouChina
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Allena N, Khanal S, Jog A, Duran MJ, Paulino S, Bojja S, Soliman M. Decoding the Chronic Obstructive Pulmonary Disease (COPD) Puzzle: Investigating the Significance of Exacerbation Scores in Triage Decision-Making. Cureus 2023; 15:e41975. [PMID: 37593292 PMCID: PMC10427510 DOI: 10.7759/cureus.41975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex disease pathology of the lungs that has a significant impact on global health. It has been a major contributor to global mortality and morbidity, with COPD exacerbations posing a substantial economic burden on the healthcare systems. Appropriate triaging of patients with COPD exacerbation is crucial to reduce the burden of hospitalization, especially in the intensive care unit (ICU). Understanding the significance of exacerbation scores in triage decision-making is essential for improving outcomes and optimizing patient care. To aid this triage decision-making, several scoring systems have been developed. This review article aims to discuss the different scores, including assessment of Confusion, Urea, Respiratory rate, Blood pressure, and Age (≥65 years) (CURB-65); Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF), Neutrophil to lymphocyte ratio (NLR); Platelet-lymphocyte ratio (PLR); Pneumonia severity index/Pneumonia Patient Outcomes Research Team (PSI/PORT); and elevated BUN, Altered mental status, Pulse, Age (>65 years) (BAP-65), and their role in triaging COPD exacerbations. Proper triaging allows for the appropriate allocation of resources and timely interventions based on severity. Further research and validation are needed to establish the optimal use and integration of these scores in clinical practice, particularly in ICU settings.
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Affiliation(s)
| | - Sneha Khanal
- Internal Medicine, BronxCare Health System, Bronx, USA
| | - Abhishrut Jog
- Pulmonary Medicine, BronxCare Health System, Bronx, USA
| | - Maria J Duran
- Internal Medicine, Bronx Care Health System, Bronx, USA
| | | | | | - Maryam Soliman
- Pulmonary and Critical Care Medicine, BronxCare Health System, Bronx, USA
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Zhou J, Tian X. MKL-SING: A data-driven approach of sign recognition for managing and improving public services. Inf Process Manag 2023. [DOI: 10.1016/j.ipm.2022.103243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Giri M, He L, Hu T, Puri A, Zheng X, Dai H, Guo S. Blood Urea Nitrogen Is Associated with In-Hospital Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Propensity Score Matching Analysis. J Clin Med 2022; 11:jcm11226709. [PMID: 36431186 PMCID: PMC9699438 DOI: 10.3390/jcm11226709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/28/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Elevated blood urea nitrogen (BUN) level is associated with a higher risk of mortality in various diseases; however, the association between BUN level and in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to the intensive care unit (ICU) is not known. This study aimed to investigate the relationship between BUN level and in-hospital mortality in patients with AECOPD admitted to the ICU. Methods: In this retrospective cohort study, AECOPD patients were identified from the Medical Information Mart for Intensive Care (MIMIC-IV) database. Multivariate regression was used to elucidate the relationship between BUN level and in-hospital mortality, and propensity score matching (PSM) was used to adjust confounders. Receiver operating characteristics and Kaplan−Meier curves were used to evaluate the relationship between BUN level and in-hospital mortality. Results: Data from 1201 patients were analyzed. The all-cause in-hospital mortality was 13.7%. BUN levels were significantly higher in non-survivors compared to the survival group before (p < 0.001) and after (p = 0.005) PSM. Multivariate analysis indicated that elevated BUN levels were independently associated with increased risk of in-hospital mortality both before (p = 0.002) and after (p = 0.015) PSM. The optimal BUN cut-off value for in-hospital mortality in critical patients with AECOPD before (>23 mg/dL) and after (>22 mg/dL) PSM was comparable. Compared with the low BUN group, the hazard ratio (HR) of the high BUN group was 1.8987 (before PSM) and 1.7358 (after PSM). Conclusions: Higher BUN levels were significantly associated with an increased risk of in-hospital mortality in critically ill patients with AECOPD. As a widely available and rapidly measured biomarker, BUN may be useful in the risk stratification of critically ill AECOPD patients. The results need to be verified in prospective studies.
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Affiliation(s)
- Mohan Giri
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1 Youyi Road, Yuzhong, Chongqing 400016, China
| | - Lin He
- Department of Respiratory and Critical Care Medicine, Chongqing University Fuling Hospital, Chongqing 408000, China
| | - Tianyang Hu
- Precision Medicine Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
| | - Anju Puri
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1 Youyi Road, Yuzhong, Chongqing 400016, China
| | - Xiaozhuo Zheng
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1 Youyi Road, Yuzhong, Chongqing 400016, China
| | - Haiyun Dai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1 Youyi Road, Yuzhong, Chongqing 400016, China
| | - Shuliang Guo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No 1 Youyi Road, Yuzhong, Chongqing 400016, China
- Correspondence:
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Cheng Y, Li L, Tu X, Pei R. The Main Pulmonary Artery to the Ascending Aorta Diameter Ratio (PA/A) as a Predictor of Worse Outcomes in Hospitalized Patients with AECOPD. Int J Chron Obstruct Pulmon Dis 2022; 17:1157-1165. [PMID: 35601020 PMCID: PMC9122045 DOI: 10.2147/copd.s357696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/30/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose The main pulmonary artery (PA) to ascending aorta diameter ratio (PA/A) greater than one is a promising indicator of pulmonary hypertension (PH) in acute exacerbation (AE) of chronic obstructive pulmonary disease (COPD) (AECOPD). This study aims to disclose the associations between the PA/A ratio and clinical outcomes in hospitalized patients with AECOPD. Patients and Methods Consecutive AECOPD patients admitted to the Department of Respiratory Medicine from September 2017 to July 2021 were reviewed. The treatment success of AECOPD patients was defined as improvement in the clinical condition when discharged from the hospital. Conversely, treatment failure was considered to be an event of in-hospital death or deterioration of the clinical condition prior to discharge. Results A total of 118 individuals were ultimately reviewed in this study: 74 individuals with a PA/A ratio <1 and 44 individuals with a PA/A ratio ≥1. The outcomes of 21 patients were treatment failure, and 97 patients were considered successes. Patients with a PA/A ratio ≥1 had significantly higher PaCO2, red cell distribution width, brain natriuretic peptide, PA diameters, RICU admission rates, and proportions of treatment failure than patients with PA/A ratios <1 (P < 0.05). The PA diameter and PA/A ratio were significantly increased in the treatment failure group compared with the success group (P < 0.05). A survival analysis indicated that patients with a PA/A ratio ≥1 had worse outcomes than patients with a PA/A ratio <1 during hospitalization (P < 0.05). A multivariate analysis showed that a PA/A ratio ≥1 was an independent risk factor for treatment failure in patients with AECOPD. Conclusions AECOPD patients with a PA/A ratio ≥1 may have worse outcomes during hospitalization. A PA/A ratio ≥1 may be a promising predictor of treatment failure in patients with AECOPD.
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Affiliation(s)
- Yusheng Cheng
- Department of Respiratory Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, People’s Republic of China
| | - Lingling Li
- Department of Respiratory Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, People’s Republic of China
| | - Xiongwen Tu
- Department of Respiratory Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, People’s Republic of China
| | - Renguang Pei
- Department of Interventional Therapy, Yijishan Hospital, Wannan Medical College, Wuhu, People’s Republic of China
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Zheng Z, Yang C, Cai C, Zhu H. The Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio Predicts Disease-Free Survival in Resectable Esophageal Squamous Cell Carcinoma. Cancer Manag Res 2021; 13:7511-7516. [PMID: 34621132 PMCID: PMC8491786 DOI: 10.2147/cmar.s321326] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/20/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent studies have revealed that the presence of systemic inflammation is associated with poor survival for esophageal squamous cell carcinoma. We aimed to investigate prognostic values of preoperative neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in resectable esophageal squamous cell carcinoma. METHODS A cohort of 167 resectable ESCC patients was retrospectively reviewed between January 2017 and September 2020. The best cut-off value of NLR and PLR was selected by plotting the receiver operating characteristic curve. All reviewed patients were divided into high NLR/PLR or low NLR/PLR group to evaluate prognostic factors. RESULTS Among the 167 patients, 34 (20.36%) were women and 133 (79.64%) were men. The mean age was 62.64 ±7.91 years, with an age range from 44 to 85 years. All patients were divided into low NLR (<2.20) or high NLR (≥2.20) group (AUC=62.5% with the sensitivity of 61.8% and specificity 60.9%, P=0.025), low PLR (<110) or high PLR (≥110) group (AUC=59.6% with the sensitivity of 82.4% and specificity 35.3%, P=0.083). High NLR and PLR were associated with a larger tumor diameter (P<0.05), while high NLR was also associated with poor tumor classification (P=0.022). There was a positive correlation between NLR and PLR (r = 0.614, P < 0.001). High NLR and PLR were significantly associated with poor disease-free survival. Multivariate analyses identified NLR as a prognostic factor in resectable ESCC. CONCLUSION The NLR and PLR predict disease-free survival in resectable esophageal squamous cell carcinoma.
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Affiliation(s)
- Zhiwei Zheng
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, People’s Republic of China
| | - Cui Yang
- Department of Obstetrics and Gynecology Shantou Central Hospital, Shantou, 515000, People’s Republic of China
| | - Chun Cai
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, People’s Republic of China
| | - Huide Zhu
- Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, People’s Republic of China
- Correspondence: Huide Zhu Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Shantou, 515041, People’s Republic of ChinaTel +86 075488555844-1140Fax +86 0754 88555844 Email
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