Role of novel hematological biomarkers in assessing chronic obstructive pulmonary disease (COPD) patients and their public health implications.

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disorder marked by airflow limitation, often exacerbated by systemic inflammation. Identifying reliable, cost-effective biomarkers to assess disease severity, and predict acute exacerbations remains a clinical priority. This study aimed to evaluates the utility of hematological biomarkers-Immature Platelet Fraction (IPF), Absolute Immature Platelet Count (AIPC), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Immune Inflammation Index (SII) in assessing COPD severity and exacerbation risk. A retrospective cross-sectional study was conducted with 136 COPD patients at the All India Institute of Medical Sciences (AIIMS), Rajkot, India. Demographic, spirometric, and hematological data were analyzed using IBM SPSS v27. Statistical methods included Chi-square tests, independent sample t-tests, ANOVA with post-hoc Tukey analysis, and Pearson correlation. Of the 136 patients (80% male, mean age 64 years), 37.5% experienced acute exacerbations. Significant associations were found between gender and exacerbation (<i>P</i> = 0.007), but not with COPD severity. Patients with exacerbations showed significantly higher IPF (<i>P</i> = 0.019), NLR (<i>P</i> = 0.049), PLR (<i>P</i> = 0.019), and SII (<i>P</i> = 0.027). IPF and AIPC increased with COPD severity (<i>P</i> < 0.01). All five biomarkers were negatively correlated with FEV1/FVC ratio, with SII showing the strongest association (<i>r</i> = -0.283, <i>P</i> < 0.001). IPF, AIPC, NLR, PLR, and SII are elevated in severe COPD and during exacerbations, offering cost-effective tools for risk stratification and monitoring. These biomarkers can support public health initiatives by enabling early intervention, reducing healthcare costs, and improving outcomes in resource-limited settings.