Analysis of the Platelet-Lymphocyte Ratio on 90-Day Mortality Following Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) remains a significant global health concern, with acute exacerbations contributing substantially to increased mortality. The platelet-to-lymphocyte ratio (PLR) has emerged as a simple inflammatory marker with potential prognostic utility; however, its role in predicting 90-day mortality among Indonesian patients with COPD has not been well established. This prospective cohort study included 81 hospitalized COPD patients aged 40 years or older from July 2024 to February 2025. PLR levels were measured upon admission, and patient survival was evaluated after 90 days. The majority of participants were male (88.9%), aged 60 years or older (72.8%), and had a history of smoking (77.8%). The mean PLR was significantly higher in non-survivors (533.29) compared to survivors (174.24; p = 0.035). A PLR threshold of 242.7 demonstrated a sensitivity and specificity of 50%. Additionally, platelet count showed a negative correlation with disease severity (r = –0.257; p = 0.021). These findings suggest that elevated PLR is associated with increased 90-day mortality in patients with acute exacerbations of COPD, although its accuracy as a standalone prognostic tool is limited.