Eosinophils in COPD Exacerbations Are Associated With Increased Readmissions

Couillard, Simon; Larivée, Pierre; Courteau, Josiane; Vanasse, Alain

doi:10.1016/j.chest.2016.10.003

Cited by 151 publications

(165 citation statements)

References 24 publications

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“…The authors speculated that osteopenia in bacterial infections might be the consequence of circulating eosinophil chemotaxis and sequestration in tissues . It is worth noting that in our study, only one participant had eosinopenia as defined in previous studies by eosinophil count <0.40/mm 3, Conflicting with these findings, other research suggests that blood eosinophils are associated with increased risk of COPD exacerbation and hospital admissions . The role of eosinophils in COPD and the reason why low eosinophil counts may be associated with poor prognosis in COPD is unclear.…”

Section: Discussioncontrasting

confidence: 83%

“…38 It is worth noting that in our study, only one participant had eosinopenia as defined in previous studies by eosinophil count <0.40/mm 3,39 Conflicting with these findings, other research suggests that blood eosinophils are associated with increased risk of COPD exacerbation and hospital admissions. 39,40 The role of eosinophils in COPD and the reason why low eosinophil counts may be associated with poor prognosis in COPD is unclear. Eosinophils originate from the bone marrow and migrate to the digestive and thymus organs.…”

Section: Discussionmentioning

confidence: 99%

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Blood biomarkers as predictors of long‐term mortality in COPD

Mendy

Forno

Niyonsenga

et al. 2018

Clinical Respiratory J

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Blood biomarkers as predictors of long‐term mortality in COPD

Mendy

Forno

Niyonsenga

et al. 2018

Clinical Respiratory J

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“…In our case, they are patients who require hospital admission, with a mean age of 74 years, with 79.1% being males. The majority of authors included a younger population, with a mean age of between 64 and 72 years, and a lower percentage of males, which in few cases exceed 60% of the patients included . Other authors include patients after a hospital admission, as in our case, others from chest disease clinics, or a general population …”

Section: Discussionmentioning

confidence: 99%

Blood eosinophils could be useful as a biomarker in chronic obstructive pulmonary disease exacerbations

Barcala

San-Jose²,

Nieto‐Fontarigo

et al. 2019

Int J Clin Pract

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Summary IntroductionThe aim of analysing the usefulness of the blood eosinophil count (BEC) as a prognostic marker in exacerbations of patients with Chronic Obstructive Pulmonary Disease (COPD), evaluating its relationship with hospital mortality, the length of stay and the early and late re‐admissions. Materials and MethodsWe have carried out a retrospective study including all patients who required hospital admission from 1 January 2008 to 31 December 2009, with a diagnosis on hospital discharge of COPD exacerbation. These patients were classified using three cut‐off points of BEC: less than 200 vs ≥ 200/µL, less than 300 vs ≥ 300/µL and less than 400 vs ≥ 400/µL. ResultsThere were a total of 1626 hospital admissions during the study period with the diagnosis of exacerbation of COPD. In this study we have included 358 patients. The probability of any late re‐admission increased with a BEC ≥ 300/µL (odds ratio: 1.684) and for those with a BEC ≥ 400/µL (odds ratio: 2.068). The BEC does not appear to be related to hospital mortality or the probability of early re‐admission after an exacerbation of COPD. ConclusionsIn our study an elevated BEC is associated with a higher incidence of late hospital readmissions in COPD exacerbations.

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“…Elevated IgE concentrations are found in up to half of patients with COPD, 24 25 and eosinophilic subtypes of COPD are well described in the literature. [26][27][28][29][30] The debate about which level of peripheral eosinophil count to ascribe to ACOS, whether above 2%, 3%, 5%, or instead using an absolute measurement, has also not been resolved. [21][22][23][24][25][26][27][28][29][30][31][32][33] A FeNO cut-off of above 35 ppb may correlate with a post-bronchodilator FEV 1 response greater than 200 mL and atopy in patients with COPD, 25 34 but the few studies that have looked at FeNO in ACOS seem to offer conflicting evidence of the test's discriminatory power.…”

Section: Introductionmentioning

confidence: 99%

Asthma-COPD overlap syndrome: pathogenesis, clinical features, and therapeutic targets

Leung

Sin

2017

BMJ

136

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Asthma-COPD overlap syndrome (ACOS) or asthma-COPD overlap captures the subset of patients with airways disease who have features of both asthma and chronic obstructive pulmonary disease (COPD). Although definitions of ACOS vary, it is generally thought to encompass persistent airflow limitation in a patient older than 40 years of age with either a history of asthma or large bronchodilator reversibility. ACOS affects about a quarter of patients with COPD and almost a third of patients who previously had asthma. Compared with their counterparts with asthma or COPD alone, patients with ACOS have significantly worse respiratory symptoms, poorer quality of life, and increased risk of exacerbations and hospital admissions. Whether this condition emerges after gradual shifts in airway remodelling and inflammation in a patient with COPD, as the result of noxious exposures in a patient with asthma, or even as a de novo disease with its own pathology is yet to be determined. Nevertheless, using treatments developed for asthma or COPD that target eosinophilic, neutrophilic, or paucigranulocytic airway inflammation may be a helpful approach to these patients until further clinical trials can be performed.

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Eosinophils in COPD Exacerbations Are Associated With Increased Readmissions

Cited by 151 publications

References 24 publications

Blood biomarkers as predictors of long‐term mortality in COPD

Blood biomarkers as predictors of long‐term mortality in COPD

Blood eosinophils could be useful as a biomarker in chronic obstructive pulmonary disease exacerbations

Asthma-COPD overlap syndrome: pathogenesis, clinical features, and therapeutic targets

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