Blood eosinophilia as a marker of early and late treatment failure in severe acute exacerbations of COPD

Prins, Hendrik J.; Duijkers, Ruud; Lutter, René; Daniëls, Hans; Valk, Paul van der; Schoorl, Margreet; Kerstjens, Huib A. M.; Werf, Tjip S. van der; Boersma, Wim

doi:10.1016/j.rmed.2017.07.064

Cited by 38 publications

(59 citation statements)

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“…Findings of this paper suggested that the test group was significantly superior to the control group in terms of psychological status, duration of clinical symptom remission, pulmonary function, quality of life, and nursing satisfaction degree of patients (P<0.05). These findings also showed good agreement with the research results of previous scholars [10], thereby further substantiating the superiority of humanistic nursing to routine nursing and suggesting that humanistic nursing is worthy of further promotion in clinical treatment.…”

Section: Discussionsupporting

confidence: 88%

Observation on the clinical effects of humanistic nursing on the psychological status of patients with COPD in acute phase

Wang¹,

Liu²

2018

biomedicalresearch

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Objectives: This study aimed to explore the clinical effects of humanistic nursing on patients with Chronic Obstructive Pulmonary Disease (COPD) in the acute phase. Methods: The random number table was adopted to divide 120 patients into for the control group (n=60) and the test group (n=60). These patients had COPD in the acute phase, and they received medical treatment from May 2016 to August 2017 in the hospital where the author worked. Routine nursing was provided to the control group, whereas humanistic nursing was given to the test group. Then, the two groups of patients were comparatively analysed in terms of psychological status, duration of clinical symptom remission, pulmonary functions, quality of life, and nursing satisfaction degree. Results: The depression and anxiety scoring of the test group was significantly lower than that of the control group (P<0.05). The duration of body temperature decrease, asthma remission, and coughing remission of the test group were significantly shorter than that of the control group (P<0.05). As compared with the control group, the test group scored significantly higher in terms of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), Maximum Mid-Expiratory Flow volume (MMFF), material life, physical functions, psychological functions, social functions, and nursing satisfaction (P<0.05). Conclusions: The clinical effects of humanistic nursing on patients with COPD in acute phase were significant. With humanistic nursing, patients with COPD in acute phase could obtain their psychological status, and their pulmonary function effectively improved; they took shorter time to recover from clinical symptoms, lived a high quality of life, and showed a high satisfaction degree for the nursing. All these positive clinical effects suggested that humanistic nursing is worthy of further promotion and application in the clinical treatment of patients with COPD in the acute phase.

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Section: Discussionsupporting

confidence: 88%

Observation on the clinical effects of humanistic nursing on the psychological status of patients with COPD in acute phase

Wang¹,

Liu²

2018

biomedicalresearch

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“…The findings on length of stay are consistent with those of a recent retrospective case note review of patients attending the emergency department of a single hospital with an acute exacerbation of COPD, although this larger study found a higher mortality rate in non‐eosinophilic exacerbations . In another study, a higher short‐term treatment success rate was seen in patients with blood eosinophils ≥2% but these patients had an increased relapse risk subsequently . There is therefore mounting and increasingly robust evidence that acute eosinophilic COPD exacerbations are associated with a shorter hospital length of stay, even if severe, almost certainly because these events are more corticosteroid responsive …”

supporting

confidence: 81%

COPD exacerbation phenotypes: The next frontier

Moran

Pavord

2019

Respirology

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“…These cut-off values were chosen as they also used similar values in their previous studies. It was noted that 18.8% had eosinophilia ≥2%, and 11.1% had blood eosinophil ≥300 cell/μl in the study by Prins et al 7 We have excluded subjects with a diagnosis of asthma from participating in this study and the percentage of subjects on inhaled corticosteroid (ICS) treatment before admission was similar to the study by Bafadhel et al 6 As in the study by Bafadhel et al, 6 we did not collect information on the days of onset of symptoms before admission. It is unclear if these could affect the peripheral eosinophil count of the subjects.…”

Section: Discussionmentioning

confidence: 86%

“…However, a significant proportion of exacerbations show eosinophilic airway inflammation . Blood eosinophilia is not infrequently encountered in patients with AECOPD . A previous study has shown that peripheral blood eosinophil count is a surrogate biomarker for eosinophil‐associated AECOPD .…”

Section: Introductionmentioning

confidence: 99%

“…5 Blood eosinophilia is not infrequently encountered in patients with AECOPD. 6,7 A previous study has shown that peripheral blood eosinophil count is a surrogate biomarker for eosinophil-associated AECOPD. 5 An eosinophil count of ≥200 cells/mL and/or ≥2% of the total leucocyte count was associated with shorter hospital length of stay (LOS) during hospitalization for AECOPD.…”

Section: Introductionmentioning

confidence: 99%

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Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations

Chan

Ngai

et al. 2019

Respirology

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Background and objective Airway inflammation accompanying exacerbations varies among individuals with some having neutrophilic, while others showing eosinophilic inflammation. This study assessed the cut‐off values of blood eosinophil count for identifying subjects with longer hospital length of stay (LOS) with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Methods Patients were recruited at presentation to the hospital with an AECOPD. Complete blood picture with differential count was taken on admission. Patients were treated with a standard course of systemic corticosteroid and antibiotic and evaluated at 8 weeks post‐exacerbation for lung function measurement and 6‐min walk. They were followed up in 1 year for any readmissions or mortality. Cut‐off values of eosinophils for assessment of longer LOS were calculated using receiver operating characteristic (ROC) curve analysis. Results A total of 346 patients with admission eosinophil count were included in the analysis (333 (96.2%) were males; mean ± SD age: 74.9 ± 7.8 years; mean forced expiratory volume in 1 s (FEV1): 43.4 ± 16.3% predicted). The median (interquartile range (IQR)) of the absolute peripheral eosinophil count, percent eosinophil count and LOS were 0.11 (0.25) × 109/L, 1 (3) % and 5 (7) days, respectively. Using the median LOS of ≥5 days as the cut‐off, ROC analysis of the cut‐off value of eosinophil count associated with longer LOS was at <2% (area under the curve (AUC): 0.666, P < 0.001) while absolute eosinophil count was at <0.144 × 109/L (AUC: 0.645, P < 0.001). These eosinophil cut‐off values could predict longer LOS independent of age, lung function and previous hospital admissions, but had no association with readmissions for AECOPD and mortality at 12 months. Conclusion An eosinophil value of <0.144 × 109/L on admission or <2% was associated with longer hospital LOS for AECOPD.

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Blood eosinophilia as a marker of early and late treatment failure in severe acute exacerbations of COPD

Abstract: NCT01232140.

Cited by 38 publications

References 28 publications

Observation on the clinical effects of humanistic nursing on the psychological status of patients with COPD in acute phase

Observation on the clinical effects of humanistic nursing on the psychological status of patients with COPD in acute phase

COPD exacerbation phenotypes: The next frontier

Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations

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