NEUTROPHIL-TO-LYMPHOCYTE RATIO AS A MARKER OF ACUTE EXACERBATION AND DISEASE SEVERITY IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease, which consists of constant expiratory limitation of the flow of air which is not fully reversible. Neutrophil-to-Lymphocyte Ratio (NLR) is an effortless and basic parameter that is readily obtained from the simplest and easily obtainable complete blood count, even in peripheral hospitals. MATERIALS AND METHODS In our cross-sectional study a total of 100 patients with COPD, attending Coimbatore Medical College Hospital OPD was included based on the inclusion and exclusion criteria over a period of one year. All the data were entered in a data collection sheet in an Excel format and analysed using SPSS Software. Numerical values were reported using mean and standard deviation or median. Categorical values are reported using number and percentages. Using Unpaired T-test and ANOVA as Statistical Methods, Probability (p) value less than 0.05 was considered as statistically significant. RESULTS In our study we have found that age, duration of illness and the BODE index was correlated with NLR. It was also found in our study that NLR is inversely related to FEV1 and GOLD grades. The neutrophil-lymphocyte ratio was more in patients with more severity of disease shown by MMRC grading and it indicates that higher the NLR ratio more severe the disease will be on dyspnoea score. It is also raised in smoker with acute exacerbation of COPD patients. NLR was independently correlated with all parameters of BODE index with p value of 0.001. Correlation of chest x-ray and CT chest with mean NLR level for emphysema plus chronic bronchitis was 4.8 and showed statistical significance with p value of 0.001. CONCLUSION As an inexpensive, accessible and convenient assay, complete haemogram may be used as a practical means in the prediction of prognosis of patients with COPD in future clinical settings. Several types of inflammatory cells and mediators have been found to be involved in the progression of COPD. Our study evaluated the association of NLR with acute exacerbations and disease severity in COPD.