Monocyte to large platelet ratio as a diagnostic tool of pulmonary embolism in patients with acute exacerbation of COPD

Abstract

Introduction Higher prevalence of pulmonary embolism (PE) has been noted among patients with chronic obstructive pulmonary disease (COPD), which may particularly occur during acute exacerbations (AECOPD). Due to similar clinical presentation, and the lack of highly-specific laboratory tests, there is a common overuse of computed tomography pulmonary angiogram (CTPA). The introduction of an additional, simple and inexpensive diagnostic tool to help in the diagnosis of PE in patients with AECOPD would be of special interest for everyday clinical practice. Objectives To assess the usefulness of monocyte to large platelet ratio (MLPR) as a diagnostic tool of PE in patients with AECOPD. Patients and methods A retrospective evaluation was performed of patients with AECOPD and suspicion of PE, in whom CTPA was performed. MLPR was investigated as a marker of thrombosis in the analyzed group. Receiver operating characteristics (ROC) analyses were preformed to measure the accuracy of MLPR in comparison with CTPA results and to identify the MLPR cut-off value. Results In total, 101 patients (56 males; median age 72 years, range 37 to 94 years) were included to the study. MLPR showed an excellent accuracy in comparison with CTPA results: AUROC was 0.945 (95% CI: 0.904-0.986). MLPR was characterized by a good accuracy of qualitative test parameters, with high sensitivity (100%; 95%CI: 79.6-100) and specificity (85.7%; 95%CI: 75.9-92.6). Conclusions MLPR measurement appears to be a reliable, simple, inexpensive and widely-available test which may help in the differential diagnosis of PE in patients with AECOPD.