Abstract
OBJECTIVE: This study aimed to evaluate the prognostic significance of combined peripheral blood red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in predicting short-term outcomes among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: This retrospective analysis included 165 patients hospitalized for AECOPD at the Departments of General Medicine and Respiratory and Critical Care Medicine of Wusong Central Hospital between December 2023 and November 2024. Patients were divided into a poor prognosis group (64 cases) and a good prognosis group (101 cases) based on re-hospitalization for AECOPD within 3 months post-discharge. Seventy healthy individuals undergoing routine physical examination during the same period served as the control group. RDW, NLR, PLR, and MPV values were compared across the three groups. Multivariate logistic regression was performed to identify independent risk factors associated with short-term prognosis. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of individual and combined hematologic markers. RESULTS: (1) patients in the poor prognosis group exhibited significantly elevated RDW, NLR, and PLR levels compared with those in the good prognosis and control groups, with MPV values demonstrating an increasing trend (p < 0.001). (2) Multivariate logistic regression identified absolute neutrophil count and RDW as independent risk factors for poor short-term prognosis in AECOPD. (3) ROC analysis indicated that the area under the curve for combined detection of RDW, NLR, PLR, and MPV was 0.950, surpassing the predictive accuracy of each individual marker. CONCLUSION: The combined assessment of RDW, NLR, PLR, and MPV offers superior predictive value over individual indicators for short-term prognosis in AECOPD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-026-04192-4.