Prognostic Significance of Neutrophil/Lymphocyte Ratio and SOFA Score in Patients with Chronic Obstructive Pulmonary Disease Followed in Intensive Care Unit

Abstract

Objective: Chronic Obstructive Pulmonary Disease (COPD) has become one of the leading causes of increasing morbidity and mortality worldwide. Inflammation is known to play an important role in the pathogenesis of COPD. Neutrophil-lymhocyte ratio (NLR) is an inflammatory biomarker which indicates the balance of the immune system and reflecting systemic inflammation. One of the most commonly used scoring models for predicting mortality in intensive care is the Sepsis Organ Failure Assessment (SOFA) scoring. The aim of our study is to investigate the prognostic significance of NLR and SOFA score in patients admitted to the intensive care unit (ICU) with COPD. Methods: A retrospective, single-center cohort study was conducted between 01.09.2022-01.09.2024. Patients over the age of 18 who were admitted to the intensive care unit of Kırşehir Training and Research Hospital with a diagnosis of COPD. Data of age, gender, comorbidities, SOFA score, NLR, number of invasive and non-invasive mechanical ventilation days, length of hospital stay, length of ICU stay, and 30-day mortality. Logistic regression analysis was used to predict mortality. Results: Data from 259 patients were evaluated. The mean age of the patients was 72 (14). Sixty-seven patients died and 192 patients were discharged. β coefficient for the NLR was 0.014419 (p=0.0383). β coefficient for the SOFA score was 0.382920 (p<0.001). From the ROC (Receiver Operating Characteristic) curve, it appears that the model has a high AUC (Area Under Curve), which indicates that the model is quite good at distinguishing classes. SOFA score and NLR were found to be higher in deceased patients. Conlusion: In ICU follow-up, SOFA score and NLR can be examined together to early detect critically COPD patients and predict mortality.

Keywords

• COPD
• SOFA( The Sepsis Organ Failure Assessment) score
• Neutrophil-lymhocyte ratio(NLR)
• ICU
• mortality

Yoğun Bakım Ünitesinde Kronik Obstrüktif Akciğer Hastalığı Tanısıyla Takip Edilen Hastalarda Nötrofil /Lenfosit Oranı ve SOFA Skorunun Prognostik Önemi

Abstract

Amaç Kronik Obstrüktif Akciğer Hastalığı(KOAH), dünya çapında artan morbidite ve mortalitenin önde gelen nedenlerinden biri haline gelmiştir. İnflamasyonun KOAH patogenezinde önemli bir rol oynadığı bilinmektedir. Nötrofil-lenfosit oranı (NLR), bağışıklık sisteminin dengesini gösteren ve sistemik inflamasyonu yansıtan bir inflamatuar biyobelirteçtir. Yoğun bakımda mortalite tahmininde en çok kullanılan skorlama modellerinden biri Sepsis Organ Yetmezliği Değerlendirme (SOFA) skorlamasıdır. Çalışmamızın amacı, KOAH nedeniyle yoğun bakıma yatırılan hastalarda NLR ve SOFA skorunun prognostik önemini araştırmaktır. Yöntem 01.09.2022-01.09.2024 tarihleri arasında KOAH nedeni ile yoğun bakım unitesine yatırılan 18 yaş üstü hastalar retrospektif olarak incelendi. Yaş, cinsiyet, eşlik eden hastalıklar, SOFA skoru, NLR, invaziv ve noninvaziv mekanik ventilasyon gün sayısı, hastanede kalış süresi, yoğun bakımda kalış süresi ve 30 günlük mortalite verileri incelendi. Bulgular 259 hastadan alınan veriler değerlendirildi. Hastaların ortalama yaşı 72 idi(14). 67 hasta ex oldu, 192 hasta taburcu edildi. NLR için β katsayısı 0,014419 idi (p = 0,0383). SOFA skoru için β katsayısı 0,382920 idi (p < 0,001). ROC Eğrisinden, modelin yüksek bir AUC'ye sahip olduğu görünmektedir bu da modelin sınıfları ayırt etmede oldukça iyi olduğunu gösterir. Ölen hastalarda SOFA skoru ve NLR'nin daha yüksek olduğu bulundu. Sonuç Yoğun bakım takibinde, kritik KOAH hastalarının erken teşhisi ve mortalitenin öngörülmesi için SOFA skoru ve NLR birlikte incelenebilir.

Keywords

• KOAH
• SOFA( The Sepsis Organ Failure Assessment) skoru
• Nötrofil/Lenfosit oranı(NLR)
• YBÜ
• ölüm

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