7211741e6213a561b59736e7252fa046 283203.pdf caaf6576cec7fecf4efb47dd4e205322693e902b 283203.pdf 9c53ade5912780723d6003b20122dbbb1b68a6fddcccac5b539814d32812d370 283203.pdf Title: Peripheral Neutrophil-to-Lymphocyte Ratio in Bronchiectasis: A Marker of Disease Severity Subject: Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson’s P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis. Keywords: neutrophil; lymphocyte; bronchiectasis; severity; exacerbations Author: Miguel Ángel Martinez-García, Casilda Olveira, Rosa Girón, Marta García-Clemente, Luis Máiz-Carro, Oriol Sibila, Rafael Golpe, Raúl Méndez, Juan Luis Rodríguez Hermosa, Esther Barreiro, Concepción Prados, Juan Rodríguez López and David de la Rosa Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Oct 10 12:08:39 2022 CEST ModDate: Mon Oct 10 12:12:08 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 768777 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MOCBVF+VnURWPalladioL Type 1 Custom yes yes no 10 0 ODVDMU+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 CELGAI+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 UCFETY+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 WIRPUU+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 IVVSWS+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 JDUPKS+CMSY10 Type 1 Builtin yes yes no 81 0 CAMXTK+EURM10 Type 1 Builtin yes yes no 85 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 92 0 BNFKNP+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 107 0 BNFKOA+PalatinoLinotype CID TrueType Identity-H yes yes yes 110 0 BNFKOB+PalatinoLinotype TrueType WinAnsi yes yes no 116 0 BNFKPC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 119 0 BNFKNP+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 129 0 BNFKOA+PalatinoLinotype CID TrueType Identity-H yes yes yes 132 0 BNFKOB+PalatinoLinotype TrueType WinAnsi yes yes no 138 0 BNFKPC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 141 0 ZYYJXI+EURB10 Type 1 Builtin yes yes no 152 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-10-25 02:24:31 CEST RepresentationInformation: 283203.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-10-24 10:24:44 CEST Size: 768777 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 366 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Study Design Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Variables and Definitions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Children: Item: Title: The NLR and Bronchiectasis Severity Indexes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Correlations between NLR and Other Bronchiectasis Variables Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Prognostic Value of Exacerbations Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Info: Title: Peripheral Neutrophil-to-Lymphocyte Ratio in Bronchiectasis: A Marker of Disease Severity Author: Miguel Ángel Martinez-García, Casilda Olveira, Rosa Girón, Marta García-Clemente, Luis Máiz-Carro, Oriol Sibila, Rafael Golpe, Raúl Méndez, Juan Luis Rodríguez Hermosa, Esther Barreiro, Concepción Prados, Juan Rodríguez López and David de la Rosa Subject: Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson’s P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis. 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