GIÁ TRỊ CỦA TỶ SỐ BẠCH CẦU ĐA NHÂN TRUNG TÍNH/TẾ BÀO LYMPHO VÀ TIỂU CẦU/TẾ BÀO LYMPHO TRONG DỰ ĐOÁN TỬ VONG NỘI VIỆN Ở NGƯỜI BỆNH ĐỢT CẤP BỆNH PHỔI TẮC NGHẼN MẠN TÍNH

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally, with particularly high prevalence in middle-low-income countries such as Vietnam. Acute exacerbations mark a critical stage of disease progression, leading to increased hospitalization rates, deteriorating lung function, decreased quality of life and increased in-hospital mortality. In Vietnam, research on the prognostic value of NLR and PLR for in-hospital mortality in patients with acute COPD exacerbations remains limited. Therefore, we conducted this study to evaluate the predictive capability of NLR and PLR for in-hospital mortality in patients with acute COPD exacerbations. Objective: To assess the predictive value of NLR, PLR, and other risk factors for in-hospital mortality in patients hospitalized for acute COPD exacerbations. Methods: A prospective cohort study was conducted on patients diagnosed with acute COPD exacerbations in the Department of Respiratory Medicine at Gia Dinh People's Hospital from March 2024 to September 2024. Results: The study included 130 patients with CKD, recording an in-hospital mortality rate of 8.46%. The mortality group had a median NLR of 9.13, which was significantly higher than the survival group (p < 0.05), and a median PLR of 252.30, which was higher but not statistically significant (p = 0.084). ROC showed that NLR had an AUC of 0.72 and PLR had an AUC of 0.66 in predicting mortality. The optimal cut-off for NLR was 8.84 (sensitivity 63.6%, specificity 82.4%), and PLR was 211.84 (sensitivity 72.7%, specificity 63%). Multivariate regression analysis showed that NLR at admission (OR = 1.13; p = 0.028) and degree of respiratory failure (OR = 4.00; p = 0.047) were two factors associated with in-hospital mortality. Conclusion: NLR and PLR are simple inflammatory markers with value in predicting in-hospital mortality in patients with acute COPD exacerbations. Among these, NLR can be utilized as a supportive tool for risk stratification in clinical practice.