Predictive value of platelet to lymphocyte ratio for in-hospital outcome of patients admitted with diagnosis of exacerbation of COPD with type II respiratory failure

Anand Kumar Deo; Kirti Kala Kharel; Deepshikha Kharel; Santa Kumar Das

doi:10.1097/MS9.0000000000003352

Predictive value of platelet to lymphocyte ratio for in-hospital outcome of patients admitted with diagnosis of exacerbation of COPD with type II respiratory failure

Ann Med Surg (Lond). 2025 May 12;87(6):3118-3122. doi: 10.1097/MS9.0000000000003352. eCollection 2025 Jun.

Authors

Anand Kumar Deo¹, Kirti Kala Kharel², Deepshikha Kharel², Santa Kumar Das³

Affiliations

¹ Department of Internal Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
² Nobel Medical College and Teaching Hospital, Biratnagar, Nepal.
³ Department of Pulmonology and Critical Care, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

Abstract

Introduction: Exacerbations of chronic obstructive pulmonary disease (COPD) are often associated with increased local and systemic inflammation. They tend to worsen the quality of life of sufferers and increase hospital admissions and mortality. Reliable and readily available biomarkers to identify the high-risk patients are necessary to facilitate early implementation of appropriate treatment strategies.

Methods: This prospective cohort study, conducted on 110 patients, aimed to study the predictive value of platelet to lymphocyte ratio (P/L) at the time of admission for in-hospital outcome of patients admitted with a diagnosis of exacerbation of COPD with Type II respiratory failure. Patients were followed up during their entire stay at the hospital and their blood tests, clinical course and outcome were recorded. The data obtained were recorded in an Excel sheet and analyzed using Statistical Package for Social Science (SPSS) version 25. The work has been reported in line with the STROCSS criteria.

Results: Among 110 patients, 11 (10%) died during hospitalization. Mean P/L at the time of admission was 214.56 ± 84.13 among the patients who eventually died at hospital and 152.53 ± 121.19 among those who were discharged (P = 0.006).

Conclusion: Our study shows that the mean P/L at the time of admission was significantly higher in COPD patients with type II respiratory failure who died during hospitalization compared to those who were discharged. These findings suggest that the P/L could serve as potential prognostic biomarker for in-hospital mortality risk in COPD exacerbations.

Keywords: acute exacerbation; chronic obstructive pulmonary disease; in-hospital outcome; platelet to lymphocyte ratio; type II respiratory failure.