ArticleAmerican journal of translational research2026
Predictive value of admission levels of IL-6 and PCT combined with the peri-treatment change in NLR (ΔNLR) for hospital length of stay in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Article in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe accurate prediction of hospital length of stay (LOS) for patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) remains a clinical challenge. While inflammatory biomarkers like Neutrophil-to-Lymphocyte Ratio (NLR), Interleukin-6 (IL-6), and Procalcitonin (PCT) are associated with severity, the predictive value of their peri-treatment dynamic changes, particularly ΔNLR, combined for LOS is not well established.
objectiveThis study aimed to evaluate the predictive value of ΔNLR combined with admission levels of IL-6 and PCT levels for hospital LOS in patients with AECOPD.
methodsA single-center retrospective cohort study was conducted involving 328 hospitalized AECOPD patients. Patients were divided into short-LOS (≤ 7 days, n = 186) and long-LOS (> 7 days, n = 142) groups based on the average LOS. Data on demographics, clinical characteristics, and laboratory parameters (including NLR, IL-6, and PCT before and after treatment) were collected. The predictive performance of ΔNLR, IL-6, and PCT, both individually and in combination, for long LOS was assessed using Receiver Operating Characteristic (ROC) curve analysis. Multivariate logistic regression was used to identify independent risk factors for long LOS.
resultsThe long-LOS group exhibited a significantly lower ΔNLR (1.2 ± 0.8 vs. 3.5 ± 1.2, P < 0.001) and higher IL-6 [45.2 (28.1, 62.3) vs. 22.5 (15.3, 30.1) pg/mL, P < 0.001] and PCT levels [0.8 (0.4, 1.5) vs. 0.3 (0.1, 0.6) ng/mL, P < 0.001]. ΔNLR was negatively correlated with LOS (r = -0.289, P < 0.001), while IL-6 (r = 0.584) and PCT (r = 0.507) were positively correlated (both P < 0.001). The combination of ΔNLR, IL-6, and PCT demonstrated the highest predictive efficacy (AUC = 0.980, 95% CI: 0.969-0.991), significantly outperforming any single indicator or the DECAF Score (all P < 0.05). At optimal cut-offs (ΔNLR ≤ 2.1, IL-6 ≥ 33.5 pg/mL, PCT ≥ 0.4 ng/mL), sensitivity was 82.3% and specificity 85.1%. Multivariate analysis confirmed ΔNLR ≤ 2.1 (OR = 3.252), IL-6 ≥ 33.5 pg/mL (OR = 2.893), PCT ≥ 0.4 ng/mL (OR = 2.561), and admission FEV
conclusionsThe combination of peri-treatment ΔNLR, IL-6, and PCT is a potent predictor for prolonged hospitalization in AECOPD, being superior to individual biomarkers. This model, utilizing routine clinical data, can facilitate early identification of high-risk patients and optimize resource allocation.
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