Neutrophil-to-lymphocyte ratio combined with albumin to globulin ratio for predicting rheumatoid arthritis-associated pneumonia.

Abstract

Objective: Rheumatoid arthritis-associated pneumonia (RAP) is a common complication of rheumatoid arthritis (RA) and is related to poor prognosis. Inflammation plays an important role in the development of RAP. This study aims to analyze and explore the predictive value of the neutrophil/lymphocyte ratio (NLR) combined with the albumin to globulin ratio (AGR) for assessing RAP.

Methods: Data for this study were collected retrospectively from the database of Xuancheng People's Hospital between February 2021 and November 2023. Patients with RAP were assigned to the observation group (n=78), while patients with rheumatoid arthritis (RA) alone were assigned to the control group (n=75). The differences in general clinical data, NLR, and AGR were compared between the two groups. Risk factors for RAP were analyzed using univariate and multivariate Logistic regression.

Results: The observation group had significantly lower AGR levels and higher NLR levels compared to the control group (all P<0.05). Univariate and multivariate logistic regression analyses identified age (95% CI 1.265-3.468; P=0.007), glucocorticoid use (95% CI 1.187-3.187; P=0.009), usage of disease-modifying anti-rheumatic drugs (DMARDs) (95% CI 1.257-2.997; P=0.006), AGR (95% CI 1.147-3.578; P=0.012), NLR (95% CI 1.198-2.978; P=0.008) and course of disease (95% CI 11.178-2.971; P=0.005) as independent prognostic factors for RAP. In addition, the ROC curve analysis showed that joint detection of NLR and AGR had a sensitivity of 98.8% and specificity of 81.8% for predicting RAP.

Conclusion: NLR and AGR play significant roles in the occurrence and progression of RAP and can serve as predictive factors for early detection of RAP.