ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1663090
Systemic immune-inflammation index and neutrophil-to-lymphocyte ratio as biomarkers for acute exacerbation of elderly patients with chronic bronchitis
Provisionally accepted
- 1People's Liberation Army General Hospital, Beijing, China
- 2Air Force Medical University Tangdu Hospital, Xi'an, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objectives: To evaluate the clinical utility of systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) as predictive biomarkers for acute exacerbation in elderly patients with chronic bronchitis (CB). Methods: A total of 215 elderly cases with chronic bronchitis were retrospectively reviewed. Based on clinical presentation, patients were classified into stable CB (n = 93) and acute exacerbation of chronic bronchitis (AECB) (n = 122) groups. Baseline clinical parameters and laboratory indicators were collected and analyzed. Results: Compared to the stable CB group, AECB group exhibited reduced lymphocyte counts and lower levels of serum albumin, alongside relatively increased concentrations of C-reactive protein (CRP), NLR, and SII (P < 0.001). Through multivariate logistic regression, decreased albumin (Alb) levels (OR = 0.605, 95% CI: 0.493–0.741, P < 0.001), as well as higher values of CRP (OR = 1.058, 95% CI: 1.016–1.102, P = 0.006), NLR (OR = 1.505, 95% CI: 1.250–1.812, P < 0.001), and SII (OR = 1.004, 95% CI: 1.003–1.006, P < 0.001), appeared to show associations with the likelihood of AECB. Receiver operating characteristic (ROC) curve analysis indicated that, among the individual markers assessed, SII demonstrated the highest discriminatory capacity (AUC = 0.856), with albumin (AUC = 0.833), NLR (AUC = 0.823), and CRP (AUC = 0.822) yielding comparable performance. When these four indicators were combined into a single predictive model, an enhanced overall diagnostic estimate was observed (AUC = 0.970), associated with sensitivity and specificity values of approximately 86.9% and 96.8%, respectively. Conclusion: The NLR and SII may serve as inflammatory indicators for acute exacerbations among older individuals with chronic bronchitis. Alongside Alb and CRP, they appear to modestly improve the ability to distinguish between stable and exacerbated states, which could offer some supportive value in the early clinical consideration of AECB risk.
Keywords: chronic bronchitis, Acute exacerbation, Elderly, systemic immune-inflammation index, Neutrophil-to-lymphocyte ratio
Received: 10 Jul 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Zhang, Ni and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chao Zhang, People's Liberation Army General Hospital, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.