Clinical Study On The Application Of NLR,PLR,SII And SIRI To Evaluate The Prognosis Of AECOPD Patients

Background and purposeChronic obstructive pulmonary disease is particularly common disease in chronic respiratory diseases in China.The disease has a high incidence and fatality rate,bringing huge economic burden to the family and society.However,AECOPD is the major determinant of health status and prognosis in COPD patients,with a significant impact on mortality in COPD patients.Therefore,finding simple and reliable biomarkers that can accurately assess the risk of death during AECOPD hospitalization is conducive to optimizing patient management and promoting the rational allocation of medical resources.This study will evaluate the prognostic value of NLR,PLR,SII and SIRI in patients with AECOPD,in order to further improve the survival conditions and quality of life of patients.MethodsA retrospective study was conducted to study 351 patients who were hospitalized and diagnosed with AECOPD in the First Affiliated Hospital of Harbin Medical University from July 2019 to July 2021.Patients were divided into two groups according to their survival outcomes at discharge: 322 patients in the survival group and 29 patients in the death group.Univariate Logistic regression and multivariate Logistic stepwise regression were used to analyze the risk factors affecting the mortality of AECOPD patients,draw the ROC curve of NLR,PLR,SII,SIRI,calculate the area under the curve,evaluate the value of each indicator for the prognosis of AECOPD patients,and find the best indicator combination to improve the prediction efficiency.ResultsThe values of NLR,PLR,SII and SIRI in the death group were significantly higher than those in the survival group(P < 0.05).Univariate Logistic regression analysis showed that NLR,PLR,SII and SIRI were risk factors for poor prognosis of AECOPD.Multivariate Logistic stepwise regression analysis showed that NLR was an independent risk factor for predicting mortality in AECOPD patients.According to the area under the ROC curve,it can be found that in terms of the ability of individual indicators to predict AECOPD mortality,the order of predictive power is NLR > SII > SIRI > PLR.The combination of these markers can improve the sensitivity of prediction,and the combination of PCT and NLR has the strongest predictive power for adverse prognosis of AECOPD,which is significantly higher than the combination of the four new inflammatory markers(AUC 0.908 vs 0.874).Conclusions1.NLR,PLR,SII and SIRI can be used as effective predictors of poor prognosis in patients with AECOPD.2.The higher the value of NLR,PLR,SII and SIRI,the higher the mortality of AECOPD patients.3.NLR,PLR,SII,SIRI and PCT can improve the sensitivity of the prediction and improve the predictive efficacy.4.The NLR is an independent risk factor for the AECOPD case fatality rate.