Year 2020,
Volume: 2 Issue: 2, 187 - 192, 26.08.2020
İbrahim Çaltekin
,
Emre Gökçen
,
Levent Albayrak
,
Dilek Atik
,
Atakan Savrun
,
Mikail Kuşdoğan
,
Hasan Kaya
,
Sevilay Vural
,
Şeyda Tuba Savrun
References
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- Herath SC, Normansell R, Maisey S, Poole P. Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;10:CD009764. doi: 10.1002/14651858.CD009764.pub3
- Bailey C, Hewison A, Karasouli E, Staniszewska S, Munday D. Hospital care following emergency admission: a critical incident case study of the experiences of patients with advanced lung cancer and Chronic Obstructive Pulmonary Disease. J Clin Nurs. 2016;25:2168-79. doi: 10.1111/jocn.13170
- Poole P, Sathananthan K, Fortescue R. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2019;5:CD001287. doi: 10.1002/14651858.CD001287.pub6
- Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2016;138:16-27. doi: 10.1016/j.jaci.2016.05.011
- Sahin F, Kosar AF, Aslan AF, Yigitbas B, Uslu B. Serum Biomarkers in Patients with Stable and Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Comparative Study. J Med Biochem. 2019;38:503-11. doi: 10.2478/jomb-2018-0050
- Kalemci S, Akin F, Sarihan A, Sahin C, Zeybek A, Yilmaz N. The relationship between hematological parameters and the severity level of chronic obstructive lung disease. Pol Arch Intern Med. 2018;128:171-7. doi: 10.20452/pamw.4198
- Ertem AG, Yayla C, Acar B, Kirbas O, Unal S, Uzel Sener M, et al. Relation between lymphocyte to monocyte ratio and short‐term mortality in patients with acute pulmonary embolism. Clin Respir J. 2018;12:580-6. doi: 10.1111/crj.12565
- Song Y-J, Wang L-X, Hong Y-Q, Lu Z-H, Tong Q, Fang X-Z, et al. Lymphocyte to monocyte ratio is associated with response to first-line platinum-based chemotherapy and prognosis of early-stage non-small cell lung cancer patients. Tumour Biol. 2016;37:5285-93. doi: 10.1007/s13277-015-4397-8
- Gong S, Gao X, Xu F, Shang Z, Li S, Chen W, et al. Association of lymphocyte to monocyte ratio with severity of coronary artery disease. Medicine (Baltimore). 2018;97: e12813. doi: 10.1097/MD.0000000000012813
- McKeever TM, Hearson G, Housley G, Reynolds C, Kinnear W, Harrison TW, et al. Using venous blood gas analysis in the assessment of COPD exacerbations: a prospective cohort study. Thorax. 2016;71:210-5. doi: 10.1136/thoraxjnl-2015-207573
- Bas FY, Tola EN, Sak S, Cankaya BA. The role of complete blood inflammation markers in the prediction of spontaneous abortion. Pak J Med Sci. 2018;34:1381. doi: 10.12669/pjms.346.15939
- Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. Eur Respir J Suppl. 2003;41:46-53. doi: 10.1183/09031936.03.00078002
- Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347-65. doi: 10.1164/rccm.201204-0596PP
- Camiciottoli G, Bigazzi F, Bartolucci M, Cestelli L, Paoletti M, Diciotti S, et al. BODE-index, modified BODE-index and ADO-score in chronic obstructive pulmonary disease: relationship with COPD phenotypes and CT lung density changes. COPD. 2012;9:297-304. doi: 10.3109/15412555.2012.661000
- Pruitt WC, Jacobs M. Interpreting arterial blood gases: easy as ABC. Nursing. 2004;34:50-3. doi: 10.1097/00152193-200408000-00052
- Saure E, Eagan T, Jensen R, Voll-Aanerud M, Aukrust P, Bakke P, et al. Explained variance for blood gases in a population with COPD. Clin Respir J. 2012;6:72-80. doi: 10.1111/j.1752-699X.2011.00248.x
- Kelly AM. Can venous blood gas analysis replace arterial in emergency medical care. Emerg Med Australas. 2010;22:493-8. doi: 10.1111/j.1742-6723.2010.01344.x
- Amalakanti S, Pentakota MR. Pulse oximetry overestimates oxygen saturation in COPD. Respir Care. 2016;61:423-7. doi: 10.4187/respcare.04435
- Kartal M, Goksu E, Eray O, Isik S, Sayrac AV, Yigit OE, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011;18:9-12. doi: 10.1097/MEJ.0b013e328337b9b9
- Khilnani GC, Saikia N, Banga A, Sharma SK. Non-invasive ventilation for acute exacerbation of COPD with very high PaCO(2): A randomized controlled trial. Lung India. 2010;27:125-30. doi: 10.4103/0970-2113.68308
- Aksoy E, Karakurt Z, Gungor S, Ocakli B, Ozmen İ, Yildirim E, et al. Neutrophil to lymphocyte ratio is a better indicator of COPD exacerbation severity in neutrophilic endotypes than eosinophilic endotypes. Int J Chron Obstruct Pulmon Dis. 2018;13:2721-30. doi: 10.2147/COPD.S170353
- Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol. 2016;26:372-6. doi: 10.3109/14397595.2015.1091136
- Rovina N, Dima E, Gennimata SA, Vakali S, Koutsoukou A, Koulouris N. Neutrophil/lymphocyte (NLR) ratio in infectious acute exacerbations of COPD (AECOPD). Eur Respir J. 2014;44:3997.
- Ren H, Liu X, Wang L, Gao Y. Lymphocyte-to-monocyte ratio: a novel predictor of the prognosis of acute ischemic stroke. J Stroke Cerebrovasc Dis. 2017;26:2595-602. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.019
- Demirtaş E, Demirtaş E. Diagnostic value of neutrophil to lymphocyte ratio to rule out chronic obstructive pulmonary disease exacerbation from acute heart failure in the emergency department. Disaster Emerg Med J. 2019;4(3):102-8. doi: 10.5603/DEMJ.2019.0021
- RahimiRad S, RahimiRad M, Ghaffari M. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute exacerbation of COPD. Eur Respir J. 2017; 50: PA3644. doi: 10.1183/1393003.congress-2017.PA3644
- Sethi S. Infection as a comorbidity of COPD. Eur Respir J. 2010;35:1209-15. doi: 10.1183/09031936.00081409
- Oliver P, Buno A, Alvarez-Sala R, Fernandez-Calle P, Alcaide MJ, Casitas R, et al. Clinical, operational and economic outcomes of point-of-care blood gas analysis in COPD patients. Clin Biochem. 2015;48:412-8. doi: 10.1016/j.clinbiochem.2014.12.020
- Mapel DW, Dalal AA, Johnson P, Becker L, Hunter AG. A clinical study of COPD severity assessment by primary care physicians and their patients compared with spirometry. Am J Med. 2015;128:629-37. doi: 10.1016/j.amjmed.2014.12.018
- Furutate R, Ishii T, Motegi T, Hattori K, Kusunoki Y, Gemma A, et al. The neutrophil to lymphocyte ratio is related to disease severity and exacerbation in patients with chronic obstructive pulmonary disease. Intern Med. 2016;55:223-9. doi: 10.2169/internalmedicine.55.5772
Inflammatory markers and blood gas analysis in determining the severity of Chronic Obstructive Pulmonary Disease
Year 2020,
Volume: 2 Issue: 2, 187 - 192, 26.08.2020
İbrahim Çaltekin
,
Emre Gökçen
,
Levent Albayrak
,
Dilek Atik
,
Atakan Savrun
,
Mikail Kuşdoğan
,
Hasan Kaya
,
Sevilay Vural
,
Şeyda Tuba Savrun
Abstract
Abstract
Aim: This study aimed to evaluate the severity of the disease using inflammatory markers in patients with Chronic Obstructive Pulmonary Disease (COPD) who admitted to the emergency department.
Materials and Methods: 193 COPD patients who applied to the emergency department were included in this retrospective study. Patients were divided into two groups according to the severity of COPD. The presence of type 1 and type 2 respiratory failure was used to create Group 2 (severe, very severe, life-threatening) and in the absence, Group 1 (mild, moderate). Inflammatory markers such as Neutrophil / lymphocyte ratio (NLR), Platelet / lymphocyte ratio (PLR), Lymphocyte / monocyte ratio (LMR) and disease severity were evaluated for both groups.
Results: The high COPD severity group (Group 2) had higher NLR and PLR values (p <0.001, p <0.001, respectively), and LMR values were lower (p <0.001). There was infection in 46.2% of Group 2, while this rate was 13.5% in Group 1 (p <0.001).
Conclusion: As the severity of the disease increases, NLR, PLR values increase, and LMR value decreases. This indicates that COPD attack will be severe in the presence of infection in COPD patients.
References
- Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2017;9:CD002309. doi: 10.1002/14651858.CD002309.pub5
- Herath SC, Normansell R, Maisey S, Poole P. Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;10:CD009764. doi: 10.1002/14651858.CD009764.pub3
- Bailey C, Hewison A, Karasouli E, Staniszewska S, Munday D. Hospital care following emergency admission: a critical incident case study of the experiences of patients with advanced lung cancer and Chronic Obstructive Pulmonary Disease. J Clin Nurs. 2016;25:2168-79. doi: 10.1111/jocn.13170
- Poole P, Sathananthan K, Fortescue R. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2019;5:CD001287. doi: 10.1002/14651858.CD001287.pub6
- Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2016;138:16-27. doi: 10.1016/j.jaci.2016.05.011
- Sahin F, Kosar AF, Aslan AF, Yigitbas B, Uslu B. Serum Biomarkers in Patients with Stable and Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Comparative Study. J Med Biochem. 2019;38:503-11. doi: 10.2478/jomb-2018-0050
- Kalemci S, Akin F, Sarihan A, Sahin C, Zeybek A, Yilmaz N. The relationship between hematological parameters and the severity level of chronic obstructive lung disease. Pol Arch Intern Med. 2018;128:171-7. doi: 10.20452/pamw.4198
- Ertem AG, Yayla C, Acar B, Kirbas O, Unal S, Uzel Sener M, et al. Relation between lymphocyte to monocyte ratio and short‐term mortality in patients with acute pulmonary embolism. Clin Respir J. 2018;12:580-6. doi: 10.1111/crj.12565
- Song Y-J, Wang L-X, Hong Y-Q, Lu Z-H, Tong Q, Fang X-Z, et al. Lymphocyte to monocyte ratio is associated with response to first-line platinum-based chemotherapy and prognosis of early-stage non-small cell lung cancer patients. Tumour Biol. 2016;37:5285-93. doi: 10.1007/s13277-015-4397-8
- Gong S, Gao X, Xu F, Shang Z, Li S, Chen W, et al. Association of lymphocyte to monocyte ratio with severity of coronary artery disease. Medicine (Baltimore). 2018;97: e12813. doi: 10.1097/MD.0000000000012813
- McKeever TM, Hearson G, Housley G, Reynolds C, Kinnear W, Harrison TW, et al. Using venous blood gas analysis in the assessment of COPD exacerbations: a prospective cohort study. Thorax. 2016;71:210-5. doi: 10.1136/thoraxjnl-2015-207573
- Bas FY, Tola EN, Sak S, Cankaya BA. The role of complete blood inflammation markers in the prediction of spontaneous abortion. Pak J Med Sci. 2018;34:1381. doi: 10.12669/pjms.346.15939
- Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. Eur Respir J Suppl. 2003;41:46-53. doi: 10.1183/09031936.03.00078002
- Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347-65. doi: 10.1164/rccm.201204-0596PP
- Camiciottoli G, Bigazzi F, Bartolucci M, Cestelli L, Paoletti M, Diciotti S, et al. BODE-index, modified BODE-index and ADO-score in chronic obstructive pulmonary disease: relationship with COPD phenotypes and CT lung density changes. COPD. 2012;9:297-304. doi: 10.3109/15412555.2012.661000
- Pruitt WC, Jacobs M. Interpreting arterial blood gases: easy as ABC. Nursing. 2004;34:50-3. doi: 10.1097/00152193-200408000-00052
- Saure E, Eagan T, Jensen R, Voll-Aanerud M, Aukrust P, Bakke P, et al. Explained variance for blood gases in a population with COPD. Clin Respir J. 2012;6:72-80. doi: 10.1111/j.1752-699X.2011.00248.x
- Kelly AM. Can venous blood gas analysis replace arterial in emergency medical care. Emerg Med Australas. 2010;22:493-8. doi: 10.1111/j.1742-6723.2010.01344.x
- Amalakanti S, Pentakota MR. Pulse oximetry overestimates oxygen saturation in COPD. Respir Care. 2016;61:423-7. doi: 10.4187/respcare.04435
- Kartal M, Goksu E, Eray O, Isik S, Sayrac AV, Yigit OE, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011;18:9-12. doi: 10.1097/MEJ.0b013e328337b9b9
- Khilnani GC, Saikia N, Banga A, Sharma SK. Non-invasive ventilation for acute exacerbation of COPD with very high PaCO(2): A randomized controlled trial. Lung India. 2010;27:125-30. doi: 10.4103/0970-2113.68308
- Aksoy E, Karakurt Z, Gungor S, Ocakli B, Ozmen İ, Yildirim E, et al. Neutrophil to lymphocyte ratio is a better indicator of COPD exacerbation severity in neutrophilic endotypes than eosinophilic endotypes. Int J Chron Obstruct Pulmon Dis. 2018;13:2721-30. doi: 10.2147/COPD.S170353
- Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol. 2016;26:372-6. doi: 10.3109/14397595.2015.1091136
- Rovina N, Dima E, Gennimata SA, Vakali S, Koutsoukou A, Koulouris N. Neutrophil/lymphocyte (NLR) ratio in infectious acute exacerbations of COPD (AECOPD). Eur Respir J. 2014;44:3997.
- Ren H, Liu X, Wang L, Gao Y. Lymphocyte-to-monocyte ratio: a novel predictor of the prognosis of acute ischemic stroke. J Stroke Cerebrovasc Dis. 2017;26:2595-602. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.019
- Demirtaş E, Demirtaş E. Diagnostic value of neutrophil to lymphocyte ratio to rule out chronic obstructive pulmonary disease exacerbation from acute heart failure in the emergency department. Disaster Emerg Med J. 2019;4(3):102-8. doi: 10.5603/DEMJ.2019.0021
- RahimiRad S, RahimiRad M, Ghaffari M. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute exacerbation of COPD. Eur Respir J. 2017; 50: PA3644. doi: 10.1183/1393003.congress-2017.PA3644
- Sethi S. Infection as a comorbidity of COPD. Eur Respir J. 2010;35:1209-15. doi: 10.1183/09031936.00081409
- Oliver P, Buno A, Alvarez-Sala R, Fernandez-Calle P, Alcaide MJ, Casitas R, et al. Clinical, operational and economic outcomes of point-of-care blood gas analysis in COPD patients. Clin Biochem. 2015;48:412-8. doi: 10.1016/j.clinbiochem.2014.12.020
- Mapel DW, Dalal AA, Johnson P, Becker L, Hunter AG. A clinical study of COPD severity assessment by primary care physicians and their patients compared with spirometry. Am J Med. 2015;128:629-37. doi: 10.1016/j.amjmed.2014.12.018
- Furutate R, Ishii T, Motegi T, Hattori K, Kusunoki Y, Gemma A, et al. The neutrophil to lymphocyte ratio is related to disease severity and exacerbation in patients with chronic obstructive pulmonary disease. Intern Med. 2016;55:223-9. doi: 10.2169/internalmedicine.55.5772