Work

Association Between Neutrophil Percentage-to-Albumin Ratio and Prolonged Length of Hospital Stay in Older Patients with Acute Exacerbation of COPD: A Retrospective Analysis

Year: 2026

Type: article

Abstract: Purpose: The neutrophil percentage-to-albumin ratio (NPAR) is a novel integrated biomarker that reflects systemic inflammation and nutritional status. In this study, we investigated the early risk-stratifying potential of the independent association between admission NPAR and length of hospital stay (LOHS) in older patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A retrospective cohort analysis was performed using clinical data from 6137 older patients (≥60 years) with AECOPD, who were hospitalized between January 2010 and March 2024 at the Affiliated Dongyang Hospital of Wenzhou Medical University, China. Admission NPAR was calculated, and prolonged LOHS was defined as >7 days. Multivariable logistic regression was used to assess the independent association between NPAR and prolonged LOHS, with restricted cubic splines to characterize the dose-response relationship. Model performance was evaluated using the area under the receiver operating characteristic curve, calibration plots, and the Hosmer-Lemeshow test. Incremental predictive value was quantified via net reclassification improvement and integrated discrimination improvement. Subgroup analyses with Bonferroni correction and a complete-case sensitivity analysis were also performed. Results: Of the 6137 eligible patients, 2923 (47.6%) experienced prolonged LOHS. After full adjustment, higher NPAR was independently associated with increased risk of prolonged LOHS (odds ratio: 2.405; 95% confidence interval: 1.904-3.046; P < 0.001), with a linear dose-response relationship (P for nonlinearity = 0.590). The NPAR-integrated model was well calibrated and showed net benefit at threshold probabilities of 15%-77%. These findings remained robust in complete-case sensitivity analysis and were consistent across most subgroups, with a stronger effect observed for males and for patients aged ≤75 years. Conclusion: Higher admission NPAR is independently associated with prolonged LOHS in older patients with AECOPD. Incorporating this accessible biomarker into initial clinical assessment may aid in the early identification of high-risk patients.

Source: International Journal of General Medicine

DOI: 10.2147/ijgm.s632408

Authors: Yan Lu, Yuan Li, Jianjie Lou, Sizhe Hu

Institution: Wenzhou Medical University

Language: English

Topic: Chronic Obstructive Pulmonary Disease (COPD) Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836