{"id":"https://openalex.org/W7213968121","doi":"https://doi.org/10.7759/cureus.116706","title":"The Prognostic Value of Baseline Neutrophil-to-Lymphocyte Ratio for Mortality in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis","display_name":"The Prognostic Value of Baseline Neutrophil-to-Lymphocyte Ratio for Mortality in Idiopathic Pulmonary Fibrosis: A Systematic Review and Meta-Analysis","publication_year":2026,"publication_date":"2026-09-22","ids":{"openalex":"https://openalex.org/W7213968121","doi":"https://doi.org/10.7759/cureus.116706","pmid":"https://pubmed.ncbi.nlm.nih.gov/42923292","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13688152"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.116706","doi":"https://doi.org/10.7759/cureus.116706","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.116706","pdf_url":"https://www.cureus.com/articles/522938-the-prognostic-value-of-baseline-neutrophil-to-lymphocyte-ratio-for-mortality-in-idiopathic-pulmonary-fibrosis-a-systematic-review-and-meta-analysis.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/522938-the-prognostic-value-of-baseline-neutrophil-to-lymphocyte-ratio-for-mortality-in-idiopathic-pulmonary-fibrosis-a-systematic-review-and-meta-analysis.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5152415225","display_name":"Suprava Shakya","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210137355","display_name":"Northern Jiangsu People's Hospital","ror":"https://ror.org/04gz17b59","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210137355"]},{"id":"https://openalex.org/I78978612","display_name":"Yangzhou University","ror":"https://ror.org/03tqb8s11","country_code":"CN","type":"education","lineage":["https://openalex.org/I78978612"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Suprava Shakya","raw_affiliation_strings":["Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, CHN"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, CHN","institution_ids":["https://openalex.org/I4210137355","https://openalex.org/I78978612"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5070674105","display_name":"Xingxiang Xu","orcid":"https://orcid.org/0000-0001-9722-0189","observed_orcids":["https://orcid.org/0000-0001-9722-0189"]},"institutions":[{"id":"https://openalex.org/I3923682","display_name":"Soochow University","ror":"https://ror.org/05t8y2r12","country_code":"CN","type":"education","lineage":["https://openalex.org/I3923682"]},{"id":"https://openalex.org/I4210137355","display_name":"Northern Jiangsu People's Hospital","ror":"https://ror.org/04gz17b59","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210137355"]},{"id":"https://openalex.org/I78978612","display_name":"Yangzhou University","ror":"https://ror.org/03tqb8s11","country_code":"CN","type":"education","lineage":["https://openalex.org/I78978612"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Xingxiang Xu","raw_affiliation_strings":["Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, CHN","Department of Respiratory Medicine, Soochow University BenQ Medical Center, Suzhou, CHN"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, CHN","institution_ids":["https://openalex.org/I4210137355","https://openalex.org/I78978612"]},{"raw_affiliation_string":"Department of Respiratory Medicine, Soochow University BenQ Medical Center, Suzhou, CHN","institution_ids":["https://openalex.org/I3923682"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5070674105"],"corresponding_institution_ids":["https://openalex.org/I3923682","https://openalex.org/I4210137355","https://openalex.org/I78978612"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.48373222,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"9","first_page":"e116706","last_page":"e116706"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11355","display_name":"Inflammatory Biomarkers in Disease Prognosis","score":0.9160000085830688,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11355","display_name":"Inflammatory Biomarkers in Disease Prognosis","score":0.9160000085830688,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10870","display_name":"Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis","score":0.07660000026226044,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.0007999999797903001,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/idiopathic-pulmonary-fibrosis","display_name":"idiopathic pulmonary fibrosis","score":0.9950000047683716},{"id":"https://openalex.org/keywords/neutrophil-to-lymphocyte-ratio","display_name":"neutrophil-to-lymphocyte ratio","score":1.0},{"id":"https://openalex.org/keywords/mortality","display_name":"mortality","score":0.8500000238418579},{"id":"https://openalex.org/keywords/prognostic-factors","display_name":"prognostic factors","score":0.9089999794960022},{"id":"https://openalex.org/keywords/systemic-inflammation","display_name":"systemic inflammation","score":0.6470000147819519},{"id":"https://openalex.org/keywords/disease-severity","display_name":"disease severity","score":0.35199999809265137}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.984499990940094},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6466000080108643},{"id":"https://openalex.org/C2776291640","wikidata":"https://www.wikidata.org/wiki/Q2912517","display_name":"Value (mathematics)","level":2,"score":0.6238999962806702},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.5371999740600586},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.4814999997615814},{"id":"https://openalex.org/C2778341716","wikidata":"https://www.wikidata.org/wiki/Q2290446","display_name":"Idiopathic pulmonary fibrosis","level":3,"score":0.42329999804496765},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.28949999809265137},{"id":"https://openalex.org/C179755657","wikidata":"https://www.wikidata.org/wiki/Q58702","display_name":"Mortality rate","level":2,"score":0.25870001316070557},{"id":"https://openalex.org/C198433322","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value of tests","level":2,"score":0.24289999902248383},{"id":"https://openalex.org/C3019719930","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value","level":2,"score":0.23720000684261322}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.116706","doi":"https://doi.org/10.7759/cureus.116706","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.116706","pdf_url":"https://www.cureus.com/articles/522938-the-prognostic-value-of-baseline-neutrophil-to-lymphocyte-ratio-for-mortality-in-idiopathic-pulmonary-fibrosis-a-systematic-review-and-meta-analysis.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13688152","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13688152/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13688152/pdf/cureus-0018-00000116706.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"},{"id":"pmid:42923292","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42923292","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.7759/cureus.116706","doi":"https://doi.org/10.7759/cureus.116706","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.116706","pdf_url":"https://www.cureus.com/articles/522938-the-prognostic-value-of-baseline-neutrophil-to-lymphocyte-ratio-for-mortality-in-idiopathic-pulmonary-fibrosis-a-systematic-review-and-meta-analysis.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7213968121.pdf","grobid_xml":"https://content.openalex.org/works/W7213968121.grobid-xml"},"referenced_works_count":35,"referenced_works":["https://openalex.org/W1914119646","https://openalex.org/W1989338939","https://openalex.org/W1994742944","https://openalex.org/W2058234974","https://openalex.org/W2090897026","https://openalex.org/W2138871107","https://openalex.org/W2168666423","https://openalex.org/W2791214769","https://openalex.org/W2805771055","https://openalex.org/W3080573042","https://openalex.org/W3105541241","https://openalex.org/W3134475107","https://openalex.org/W3144543375","https://openalex.org/W3146986272","https://openalex.org/W3180817155","https://openalex.org/W3214542774","https://openalex.org/W4205117962","https://openalex.org/W4220752225","https://openalex.org/W4225001859","https://openalex.org/W4225147016","https://openalex.org/W4283026950","https://openalex.org/W4283721346","https://openalex.org/W4310508480","https://openalex.org/W4317436785","https://openalex.org/W4372311431","https://openalex.org/W4380360917","https://openalex.org/W4386558612","https://openalex.org/W4395047395","https://openalex.org/W4400140735","https://openalex.org/W4405429142","https://openalex.org/W4407058646","https://openalex.org/W4408979151","https://openalex.org/W4412506050","https://openalex.org/W4412726077","https://openalex.org/W4414053676"],"related_works":["https://openalex.org/W4225265413","https://openalex.org/W4310508480","https://openalex.org/W3023010515","https://openalex.org/W4412726077","https://openalex.org/W4225001859","https://openalex.org/W3146986272","https://openalex.org/W4416637644","https://openalex.org/W4283026950","https://openalex.org/W4389206989","https://openalex.org/W7161594113"],"abstract_inverted_index":{"Idiopathic":[0],"pulmonary":[1,8],"fibrosis":[2],"(IPF)":[3],"is":[4,32,287],"a":[5,191,195,216,221,290],"chronic":[6],"fibrosing":[7],"disease":[9,45],"with":[10,106,233,255,289,313],"an":[11,24,33,283],"unfavorable":[12],"prognosis.":[13],"It":[14],"usually":[15],"occurs":[16],"in":[17,69,99,237,297],"the":[18,56,61,84,93,129,182,206,230,234,238,242,270,301],"older":[19],"age":[20],"group":[21],"and":[22,51,59,81,102,112,250,261,279],"shows":[23],"extremely":[25],"variable":[26],"clinical":[27,323],"course.":[28],"Neutrophil-to-lymphocyte":[29],"ratio":[30],"(NLR)":[31],"affordable,":[34],"widely":[35],"accessible":[36],"blood-based":[37],"biomarker":[38],"that":[39,155,282],"has":[40],"great":[41],"potential":[42],"for":[43,67],"evaluating":[44],"outcomes.":[46],"Therefore,":[47],"this":[48],"systematic":[49,277],"review":[50,278],"meta-analysis":[52,135,280],"aim":[53],"to":[54,88,118,127,161,212,320],"synthesize":[55],"existing":[57],"literature":[58],"analyze":[60],"prognostic":[62,94],"value":[63],"of":[64,78,96,131,198,224,272],"baseline":[65,97,157,285],"NLR":[66,98,158,286,315],"mortality":[68,104,163,295],"IPF":[70,100,143,298],"patients.":[71,144],"Literature":[72],"was":[73,125,159,178,188,209],"retrieved":[74],"from":[75,83],"PubMed,":[76],"Web":[77],"Science,":[79],"Embase,":[80],"ScienceDirect":[82],"earliest":[85],"available":[86],"records":[87],"April":[89],"2026.":[90],"Studies":[91],"investigating":[92],"role":[95],"patients":[101],"reporting":[103],"outcomes":[105],"HRs":[107],"were":[108,116,248],"included.":[109],"Random-effects":[110],"(RE)":[111],"fixed-effects":[113],"(FE)":[114],"models":[115],"used":[117,126,189],"pool":[119],"HRs.":[120],"The":[121,185,264],"Newcastle-Ottawa":[122],"Scale":[123],"(NOS)":[124],"assess":[128],"quality":[130,149],"included":[132,136],"studies.":[133],"This":[134,276],"four":[137],"retrospective":[138],"cohort":[139],"studies":[140,146,312],"comprising":[141],"1,524":[142],"All":[145],"demonstrated":[147,220],"good":[148],"(NOS":[150],"8/9).":[151],"Pooled":[152],"analysis":[153,219,267],"indicated":[154],"increased":[156,162,294],"related":[160],"risk":[164,296],"(pooled":[165],"HR":[166,223],"=":[167,173],"1.54,":[168],"95%":[169,202],"CI":[170,203,227],"0.90-2.64,":[171],"p":[172],"0.083),":[174],"although":[175,205],"statistical":[176,308],"significance":[177],"not":[179,306],"reached":[180],"under":[181,229],"RE":[183,207,231,303],"model.":[184],"FE":[186],"model":[187,208,304],"as":[190,241,257,300],"sensitivity":[192,266],"check,":[193],"yielding":[194],"similar":[196],"direction":[197,240],"association":[199,235],"(HR":[200],"1.43,":[201],"1.21-1.68),":[204],"prioritized":[210],"due":[211],"observed":[213],"heterogeneity.":[214],"Furthermore,":[215],"supplementary":[217],"exploratory":[218],"pooled":[222,274],"1.67":[225],"(95%":[226],"1.12-2.49)":[228],"model,":[232],"remaining":[236],"same":[239],"primary":[243,302],"analysis.":[244],"However,":[245],"these":[246],"analyses":[247],"exploratory,":[249],"findings":[251],"should":[252],"be":[253],"interpreted":[254],"caution":[256],"they":[258],"combine":[259],"adjusted":[260],"unadjusted":[262],"estimates.":[263],"leave-one-out":[265],"further":[268],"supported":[269],"stability":[271],"our":[273],"results.":[275],"suggest":[281],"elevated":[284],"associated":[288],"nonsignificant":[291],"trend":[292],"toward":[293],"patients,":[299],"did":[305],"reach":[307],"significance.":[309],"Prospective":[310],"multicenter":[311],"standardized":[314],"cutoff":[316],"thresholds":[317],"are":[318],"needed":[319],"verify":[321],"its":[322],"application.":[324]},"counts_by_year":[],"updated_date":"2026-10-29T09:56:32.521200","created_date":"2026-09-22T00:00:00"}
