Multi-center evaluation of baseline neutrophil:lymphocyte (NLR) ratio as an independent predictor of mortality and clinical risk stratifier in Idiopathic Pulmonary Fibrosis
Multi-center evaluation of baseline neutrophil:lymphocyte (NLR) ratio as an independent predictor of mortality and clinical risk stratifier in Idiopathic Pulmonary Fibrosis
Summary BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive, fatal disorder with a variable disease trajectory. The aim of this study was to assess the potential of neutrophil-to-lymphocyte ratio (NLR) to predict outcomes for people with IPF. MethodWe adopted a two-stage discovery and validation design using patients from the UCL partners (UCLp) cohort. For the discovery analysis, we included 71 patients from UCLH. In the validation analysis, we included 928 people with IPF, using real-life data from UCLH and 5 other UK centres. Data were collected from patients presenting over a 13-year period with a mean follow up time of 3.7 years. FindingsIn the discovery analysis, we showed that values of NLR (<2.9 vs >/=2.9) were associated with increased risk of mortality (HR 2.04, 95% CI 1.09-3.81; p=0.025). In the validation cohort we confirmed this association of high NLR with mortality (HR 1.65, 95% CI 1.39-1.95; p<0·0001) and showed incorporation of baseline NLR in a modified GAP-stage/index (GAP/index)-plus improved predictive ability InterpretationWe have identified NLR as a widely available test that significantly correlates with lung function, can predict outcomes in IPF and refines clinical GAP-staging. NLR may help ILD specialist centres prioritise at risk patients in a timely way, even in the absence of lung function.
Cope Victoria S A、Garthwaite Helen、Duckworth Anna、Scotton Chris J.、Mikolasch Theresia A、Nancarrow Thomas、Barratt Shaney L、Kouranos Vasilis、Fidan Silan、Shortman Robert、Lines Sarah、Renzoni Elisabetta A、Steward Matthew、Wells Athol U.、Gibbons Michael、Porter Joanna C.、Fallon Janet、Adamali Huzaifa I、Gooptu Bibek、Groves Ashley M、Creamer Andrew W、Sahota Jagdeep、Mackintosh John A、Woodhead Felix A.、Heightman Melissa、Hoy Luke、Win Thida、Wollerton Rebecca、Ganeshan Balaji、George Peter M.
Interstitial Lung Disease Unit, Royal Brompton HospitalInterstitial Lung Disease Service, UCLH NHS TrustAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustCollege of Medicine & Health, University of Exeter||Academic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustCITR, UCL Respiratory, UCL||Interstitial Lung Disease Service, UCLH NHS TrustCollege of Medicine & Health, University of Exeter||Academic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustBristol Interstitial Lung Disease Service, North Bristol NHS Trust||Academic Respiratory Unit, University of BristolInterstitial Lung Disease Unit, Royal Brompton Hospital||National Heart and Lung Institute, Imperial College LondonInstitute for Lung Health and Leicester Interstitial Lung Disease Service and NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital||Department of Respiratory Sciences and Leicester Institute of Structural & Chemical Biology University of LeicesterInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustInterstitial Lung Disease Unit, Royal Brompton Hospital||National Heart and Lung Institute, Imperial College LondonAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustInterstitial Lung Disease Unit, Royal Brompton Hospital||National Heart and Lung Institute, Imperial College LondonAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustCITR, UCL Respiratory, UCL||Interstitial Lung Disease Service, UCLH NHS TrustDepartment of Respiratory Medicine, Somerset Lung Centre, Musgrove Park HospitalBristol Interstitial Lung Disease Service, North Bristol NHS Trust||Academic Respiratory Unit, University of BristolInstitute for Lung Health and Leicester Interstitial Lung Disease Service and NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital||Department of Respiratory Sciences and Leicester Institute of Structural & Chemical Biology University of LeicesterInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHBristol Interstitial Lung Disease Service, North Bristol NHS Trust||Academic Respiratory Unit, University of BristolCITR, UCL Respiratory, UCL||Interstitial Lung Disease Service, UCLH NHS TrustInterstitial Lung Disease Unit, Royal Brompton Hospital||The Prince Charles HospitalInstitute for Lung Health and Leicester Interstitial Lung Disease Service and NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital||Department of Respiratory Sciences and Leicester Institute of Structural & Chemical Biology University of LeicesterInterstitial Lung Disease Service, UCLH NHS TrustInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHLister Hospital, North East Herts TrustAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHInterstitial Lung Disease Unit, Royal Brompton Hospital||National Heart and Lung Institute, Imperial College London
内科学临床医学基础医学
Cope Victoria S A,Garthwaite Helen,Duckworth Anna,Scotton Chris J.,Mikolasch Theresia A,Nancarrow Thomas,Barratt Shaney L,Kouranos Vasilis,Fidan Silan,Shortman Robert,Lines Sarah,Renzoni Elisabetta A,Steward Matthew,Wells Athol U.,Gibbons Michael,Porter Joanna C.,Fallon Janet,Adamali Huzaifa I,Gooptu Bibek,Groves Ashley M,Creamer Andrew W,Sahota Jagdeep,Mackintosh John A,Woodhead Felix A.,Heightman Melissa,Hoy Luke,Win Thida,Wollerton Rebecca,Ganeshan Balaji,George Peter M..Multi-center evaluation of baseline neutrophil:lymphocyte (NLR) ratio as an independent predictor of mortality and clinical risk stratifier in Idiopathic Pulmonary Fibrosis[EB/OL].(2025-03-28)[2025-05-18].https://www.medrxiv.org/content/10.1101/2022.04.29.22274470.点此复制
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