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Article Abstract
Background: The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a widely used inflammatory marker for predicting clinical outcomes across various diseases; however, its prognostic value in hypercapnic respiratory failure (HRF) remains uncertain. This study aimed to examine the association between NPAR and all-cause mortality in patients with HRF.
Methods: This prospective cohort study enrolled 561 HRF patients hospitalized at Yancheng First People's Hospital between October 2020 and September 2021. The primary outcome was 24-month all-cause mortality; secondary outcomes included mortality at 3, 6, and 12 months. The association between NPAR and all-cause mortality was assessed using restricted cubic spline (RCS) modeling, multivariate Cox proportional hazards models, Kaplan-Meier survival analysis, and subgroup analyses. Discriminatory performance was evaluated using the area under the receiver operating characteristic curve (AUC).
Results: RCS modeling demonstrated a significant linear association between NPAR and all-cause mortality in HRF patients (P for overall association < 0.001). Both the Cox models and Kaplan-Meier analyses indicated that elevated NPAR levels were significantly associated with increased 3-, 6-, 12-, and 24-month all-cause mortality (all P < 0.05). Subgroup analysis further supported an independent association between NPAR and mortality. The AUC for NPAR in predicting 12-month all-cause mortality was 0.66 (95% confidence interval [CI], 0.61-0.71), which was significantly higher than that of neutrophil percentage or albumin alone (AUC =0.62; 95% CI, 0.57-0.67; P < 0.05).
Conclusion: Elevated NPAR is independently associated with increased all-cause mortality in patients with HRF. As a composite marker reflecting both systemic inflammation and nutritional status, NPAR may serve as a robust prognostic indicator to enhance risk stratification and guide clinical decision-making in HRF management.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357578 | PMC |
| http://dx.doi.org/10.2147/IJGM.S520510 | DOI Listing |
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