Eosinopenia as a Predictive Factor of the Short-Term Risk of Mortality and Infection after Acute Cerebral Infarction

Hori, Yusuke S.; Kodera, Satoshi; Sato, Yasunori; Shiojiri, Toshiaki

doi:10.1016/j.jstrokecerebrovasdis.2015.12.007

Cited by 24 publications

(24 citation statements)

References 20 publications

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“…In two prospective cohort studies showed that increased eosinophils were independent predictors of cardiovascular and cerebrovascular events 16,17 . However, in most retrospective studies demonstrated that eosinopenia was associated with worse clinical outcomes in patients with cardiaccerebral vascular events 9,10,18,19 . These different results may be due to differences in the timing of blood sample obtained and in the distribution of eosinophil in different stages of diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies suggested an association of a poor prognosis, larger infarct size and hemorrhage transformation after intravenous thrombolysis or mechanical thrombectomy with initial neutrophil to lymphocyte [5][6][7][8] .Few studies showed that eosinophil is associated with mortality and severity in acute ischemic stroke (AIS) patients 9,10 . However, all of these studies mostly focused on static cell counts at baseline, which probably not re ect the complicated dynamic changes of the patients' conditions.…”

Section: Introductionmentioning

confidence: 99%

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Dynamic Change of Eosinophil and Acute Ischemic Stroke

Zhao

Feng

et al. 2020

Preprint

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Abstract Background: Eosinopenia has been shown to be a predicative factor for the infection and mortality in ischemic stroke patients which mainly focused on static eosinophil count. This study aimed to explore the relationship between dynamic change of eosinophil count and short-term prognosis of acute ischemic stroke (AIS).Methods: A total of 174 patients with AIS were respectively enrolled. Blood samples for blood routine examination were obtained at admission before any treatments and the next day. Eosinopenia was defined as the continuous decrease of the count of eosinophil from the first day to the second. Infarct volume was measured by diffusion-weighted MR imaging volume. 90-day modified Rankin Scale scores were collected to assess the prognosis of patients with AIS.Results: Patients were divided into two groups according to whether they have eosinopenia. Patients with eosinopenia were more likely to have large infarct volume (3.2 [0.6-39.9] cm3 vs 1.1 [0.3-6.0] cm3, P =.004). Receiver operating characteristic analysis demonstrated that the eosinophil count on the second day was more accurate than the time of admission to identify the large cerebral infarction (LCI) (0.866 vs 0.603, P ＜.001). Logistic regression analysis revealed that eosinopenia was independently associated with LCI (P =.015) and poor outcome (P =.011), and patients with eosinopenia had a 4.05-fold greater risk for LCL (95% CI 1.31-12.51) and a 4.29-fold greater risk for worse clinical outcomes (95% CI 1.27-14.51) than patients without.Conclusion： Eosinophil is a dynamic variable, and its variation is associated with poor outcome in acute ischemic stroke patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamic Change of Eosinophil and Acute Ischemic Stroke

Zhao

Feng

et al. 2020

Preprint

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“…Given that the percentage of eosinophils was negatively correlated with infarct volume and eosinopenia had the potential to predict the severity of AIS [7,16,17], we adjusted baseline NIHSS in the multivariable models and performed further subgroup analyses stratified by NIHSS score to eliminate the confounding effects of the severity of AIS. We found that the significant association of EMR with poor outcome was independent of the baseline NIHSS in stroke patients, especially in participants with minor stroke (NIHSS score < 4; P for interaction=0.0015 in the fully adjusted model).…”

Section: Discussionmentioning

confidence: 99%

“…That, along with the guide advises that the visual representation of the relationship between predicted and observed (not the specific P value) is the best way to evaluate calibration [17], suggest The mechanisms underlying these observations are not well established, but they seem to be related to the roles of eosinophils and monocytes in ischemic insult. Eosinophils are able to secrete over 35 cytokines, growth factors and chemokines, including IL-4, IL-13 and vascular endothelial growth factor (VEGF).…”

Section: Discussionmentioning

confidence: 99%

Eosinophil-to-monocyte ratio is a potential biomarker in the prediction of functional outcome among patients with acute ischemic stroke

Luo

Zhang

et al. 2020

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Background and PurposeIt has been showed that eosinophils are decreased and monocytes are elevated in patients with ischemic stroke, but the impact of eosinophil-to-monocyte ratio (EMR) on clinical outcomes among patients with acute ischemic stroke remains unclear. The aim of this study is to determine the relationship between EMR on admission and three-month poor functional outcome in patients with acute ischemic stroke.MethodsA total of 521 consecutive patients admitted to our hospital within 24 hours after onset of acute ischemic stroke were prospectively enrolled and categorized in terms of quartiles of EMR on admission between August 2016 and September 2018. The endpoint was the poor outcome defined as modified Rankin Scale score of 3 to 6 at month 3 after admission.ResultsAs EMR decreased, the risk of poor outcome increased (P<0.001). Logistic regression analysis revealed that EMR was independently associated with poor outcome after adjusting potential confounders (odds ratio, 0.10; 95% CI, 0.03–0.36; P=0.0004), which is consistent with the result of EMR (quartile) as a categorical variable (odds ratio, 0.24; 95% CI, 0.10–0.53; Ptrend<0.0001). A non-linear relationship was detected between EMR and poor outcome, whose point was 0.28. Subgroup analyses further confirmed these associations. The area under the curve of EMR for the prediction of poor outcome in receiver operating characteristic analysis was 0.653 (95% CI, 0.603–0.703; P=0.003). Furthermore, the addition of EMR to conventional risk factors improved the predictive power for poor outcome (net reclassification improvement: 3.54%, P=0.230; integrated discrimination improvement: 2.11%, P=0.001).ConclusionEMR on admission was independently correlated with poor outcome in patients with acute ischemic stroke, suggesting that EMR may be a potential prognostic biomarker for ischemic stroke.

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“…however, their function is not entirely clear 2,3 . Studies have shown that disease-induced hypoeosinophilia is related to adverse disease outcomes [2][3][4][5][6][7][8] , probably due to activation of inflammatory responses or immune suppression 9,10 . In recent years, the effects of anesthesia on the inflammatory immune response and prognosis have become a major research topic locally and abroad. Various anesthetics have been shown to have different effects on the immune response 11,12 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between postoperative hypoeosinophilia and hospital stay in patients undergoing hip fracture surgery under general anesthesia or spinal anesthesia: A retrospective study

Liang

Liu

Yue

et al. 2019

Preprint

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Background The inflammatory immune response is related to the development and progression of many diseases. Recent studies show that eosinophils (EOSs) are involved in various inflammatory processes and even affect patient prognosis. Various anesthetics or anesthesia methods have different effects on the immune inflammatory response. This study aimed to investigate early postoperative changes in EOSs and the relationship of postoperative recovery and hypoeosinophilia in patients undergoing hip fracture surgery under general or spinal anesthesia. Methods We retrospectively analyzed the patients who underwent hip fracture surgery at our hospital between April 2014 and November 2017. Patients were classified according to whether they received general anesthesia or spinal anesthesia. The outcome measure was postoperative hospital stay (days), and the investigating factor was postoperative day 1 EOS levels. Results A total of 149 patients were included in this study, including 34 patients in the general anesthesia group and 115 patients in the spinal anesthesia group. Postoperative day 1 EOS was lower in the general anesthesia group than that in the spinal anesthesia group (P=0.009). The correlation between postoperative hospital stay and postoperative day 1 EOS level was significant ([EOS 1× 107/L increase] β=-0.39, 95%CI -0.74, -0.05) in the general anesthesia group, after adjusting the confounders (age, gender, American Society of Anesthesiologists [ASA] grade, intraoperative blood loss, intraoperative red blood cell [RBC] transfusion, postoperative day 1 hematocrit [HCT] and white blood cell [WBC], and postoperative complications) and the interaction terms for ASA, intraoperative blood loss, intraoperative RBC transfusion and postoperative complications. Conclusion EOSs were significantly decreased after surgery in general anesthesia group, Also, postoperative hospital stay was negatively correlated with postoperative day 1 hypoeosinophilia in the general anesthesia group, suggesting that patients should be closely monitored for EOS changes and postoperative complications to enable early intervention.

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Eosinopenia as a Predictive Factor of the Short-Term Risk of Mortality and Infection after Acute Cerebral Infarction

Cited by 24 publications

References 20 publications

Dynamic Change of Eosinophil and Acute Ischemic Stroke

Dynamic Change of Eosinophil and Acute Ischemic Stroke

Eosinophil-to-monocyte ratio is a potential biomarker in the prediction of functional outcome among patients with acute ischemic stroke

The relationship between postoperative hypoeosinophilia and hospital stay in patients undergoing hip fracture surgery under general anesthesia or spinal anesthesia: A retrospective study

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