Association Between Neutrophil Percentage to Serum Albumin Ratio and in-Hospital Mortality of Patients with Chronic Obstructive Pulmonary Disease in Intensive Care Unit: A Retrospective Cohort Study

Yanfei Shi,1,* Yushan Shi,2,* Yongjuan Liu,1 Chunxiao Wang,3 Ming Qi,1 Chengwei Li4 1Department of Pulmonary Disease, The Dezhou Hospital of Traditional Chinese Medicine, Dezhou, Shandong, 253000, People’s Republic of China; 2Laboratories Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250000, People’s Republic of China; 3School of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, Shandong, 261000, People’s Republic of China; 4Department of Traditional Chinese Medicine, Dezhou Hospital of Shandong University Qilu Hospital, Dezhou, Shandong, 253000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chengwei Li, Department of Traditional Chinese Medicine, Dezhou Hospital of Shandong University Qilu Hospital, Dezhou, Shandong, 253000, People’s Republic of China, Email [email protected]: This study aimed to investigate the potential correlation between the neutrophil percentage to serum albumin ratio(NPAR) and in-hospital mortality in critically ill patients with Chronic Obstructive Pulmonary Disease (COPD).Patients and Methods: This study employed a retrospective cohort design. A total of 599 COPD patients were included in this research. Clinical data from the MIMIC-IV (Medical Information Mart for Intensive Care IV) database were utilized. To determine whether a correlation exists between NPAR and in-hospital mortality, a multivariable logistic regression analysis was conducted. Subgroup analyses were performed, taking into account factors such as age, sex, diabetes, congestive heart failure, and ventilator use.Results: Among the 599 patients studied, 114 (19.0%) experienced in-hospital mortality. In the multivariable logistic regression model, NPAR was positively correlated with in-hospital mortality; for each unit increase in NPAR, the in-hospital mortality rate increased by 5% (Odds Ratio [OR] = 1.05; 95% Confidence Interval [95% CI] = 1.02– 1.09). Compared to the lowest NPAR group, the highest NPAR group had a significantly greater risk of in-hospital mortality (OR [95% CI] = 2.15 [1.11– 4.17]). Furthermore, the results of the subgroup analyses were consistent across all groups.Conclusion: Our study reveals a correlation between NPAR levels and mortality in COPD patients. Further research is warranted to validate these findings.Keywords: chronic obstructive pulmonary disease, neutrophil percentage to serum albumin ratio, MIMIC-IV, hospital mortality, retrospective cohort study