The clinical usefulness of neutrophil percentage/albumin ratio in predicting the one-month mortality in chronic obstructive pulmonary disease patients hospitalized with community-acquired pneumonia.

BACKGROUND

Community-acquired pneumonia (CAP) is a significant cause of hospitalization in chronic obstructive pulmonary disease (COPD), negatively impacting both morbidity and mortality. The neutrophil percentage-to-albumin ratio (NPAR) is a recently introduced indicator combining systemic inflammation and nutritional status. This study aimed to clarify the prognostic significance of NPAR in predicting one-month mortality among COPD patients hospitalized with CAP.

METHODS

Medical records of the study population between January 1, 2014, and December 31, 2020, were retrospectively reviewed. NPAR values at admission were calculated. The Cox proportional hazards model was used to investigate the association between the NPAR, log NPAR, and one-month mortality. Receiver operating characteristic (ROC) analysis was performed to compare the predictive value of log NPAR with established clinical scoring systems.

RESULTS

A total of 508 patients were included in the study. Higher NPAR and log NPAR were significantly associated with one-month mortality in Cox analysis after adjustment for age and gender (HR:2.175, p:0.01 and HR:6.853, p:0.031). However, after adjusting for additional confounding factors, NPAR and long NPAR were no longer significantly associated with one-month mortality. ROC analysis demonstrated that log NPAR had a superior predictive value for one-month mortality compared to PSI and CURB-65 scores (AUC for log NPAR: 0.654, for PSI: 0.596, and CURB-65: 0.569, p:0.005). Furthermore, higher NPAR was associated with disease severity, prolonged hospital stays, and treatment-related mortality (all p < 0.05).

CONCLUSIONS

NPAR may be a useful biomarker for assessing one-month mortality, disease severity, and treatment outcomes in COPD patients with CAP. Further research is needed to determine its role in guiding therapeutic decisions.