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Multi-center evaluation of baseline neutrophil:lymphocyte (NLR) ratio as an independent predictor of mortality and clinical risk stratifier in Idiopathic Pulmonary Fibrosis

Theresia MikolaschInterstitial Lung Disease Service, UCLH NHS Trust, LondonPeter M. GeorgeImperial College LondonJagdeep SahotaInterstitial Lung Disease Service, UCLH NHS Trust, LondonT NancarrowCollege of Medicine & Health, University of ExeterShaney BarrattAcademic Respiratory Unit, University of BristolFelix WoodheadDepartment of Respiratory Sciences and Leicester Institute of Structural & Chemical Biology University of LeicesterVasileios KouranosNational Heart and Lung Institute, Imperial College LondonVictoria S.A. CopeInterstitial Lung Disease Unit, Royal Brompton HospitalAndrew CreamerBristol Interstitial Lung Disease Service, North Bristol NHS TrustSilan FidanInstitute for Lung Health and Leicester Interstitial Lung Disease Service and NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital, Groby Road, LeicesterBalaji GaneshanInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHLuke HoyInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHJohn A. MackintoshInterstitial Lung Disease Unit, Royal Brompton HospitalRobert I. ShortmanInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHAnna DuckworthAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustJanet FallonDepartment of Respiratory Medicine, Somerset Lung Centre, Musgrove Park Hospital, TauntonHelen GarthwaiteMelissa HeightmanHuzaifa AdamaliBristol Interstitial Lung Disease Service, North Bristol NHS TrustSarah LinesAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustThida WinEast and North Hertfordshire NHS TrustRebecca WollertonAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustElisabetta RenzoniNational Heart and Lung Institute, Imperial College LondonMatthew StewardAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustAthol U. WellsInterstitial Lung Disease Unit, Royal Brompton HospitalMichael GibbonsAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustAshley M. GrovesInstitute of Nuclear Medicine, UCL and Department of Nuclear Medicine UCLHBibek GooptuInstitute for Lung Health and Leicester Interstitial Lung Disease Service and NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital, Groby Road, LeicesterChris J. ScottonAcademic Department of Respiratory Medicine, Royal Devon & Exeter NHS Foundation TrustJoanna C. PorterInterstitial Lung Disease Service, UCLH NHS Trust, London

medRxivrepository2022en

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Annotatsiya

Summary Background Idiopathic 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. Method We 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. Findings In 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 Interpretation We 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.

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Mavzular

Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis Sarcoidosis and Beryllium Toxicity Research Eosinophilic Disorders and Syndromes

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DOI: 10.1101/2022.04.29.22274470

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