Association Between Neutrophil Percentage-to-Albumin Ratio and Prolonged Length of Hospital Stay in Older Patients with Acute Exacerbation of COPD: A Retrospective Analysis.
- 1Clinical Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, People's Republic of China.
- 2Department of Gastrointestinal Surgery, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, People's Republic of China.
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.
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BibTeX
@article{lu2026association,
title = {{Association Between Neutrophil Percentage-to-Albumin Ratio and Prolonged Length of Hospital Stay in Older Patients with Acute Exacerbation of COPD: A Retrospective Analysis.}},
author = {Yan Lu and Yuan Li and Jianjie Lou and Sizhe Hu},
journal = {International journal of general medicine},
year = {2026},
month = oct,
doi = {10.2147/ijgm.s632408},
url = {https://europepmc.org/article/MED/42948320},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Association Between Neutrophil Percentage-to-Albumin Ratio and Prolonged Length of Hospital Stay in Older Patients with Acute Exacerbation of COPD: A Retrospective Analysis.
AU - Yan Lu
AU - Yuan Li
AU - Jianjie Lou
AU - Sizhe Hu
PY - 2026
DA - 2026/10/23
JO - International journal of general medicine
DO - 10.2147/ijgm.s632408
UR - https://europepmc.org/article/MED/42948320
AB - 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.
SN - 1178-7074
ER -