Evaluación de la eosinopenia como marcador de infección en pacientes ingresados en una Unidad de Cuidados Intensivos

Consuegra, Ismael López de Toro Martín; Casado, Marcelino Sánchez; Villar, S. Rodríguez; Cano, Aline; Torrijos, P.; Ramos, A. Velasco; Rodríguez, P. Sánchez; Martin, Humberto

doi:10.1016/j.medin.2009.11.007

Cited by 11 publications

(9 citation statements)

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“…Several studies [4]–[8] have suggested that eosinopenia can be a marker of bacterial infection in distinct types of patients. These studies include heterogeneous populations and have a small number of patients, representing a major limitation for their interpretation, which is reflected in their contradictory results.…”

Section: Discussionmentioning

confidence: 99%

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Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

et al. 2012

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IntroductionThere is scarce evidence on the use of eosinophil count as a marker of outcome in patients with infection. The aim of this study was to evaluate whether changes in eosinophil count, as well as the neutrophil-lymphocyte count ratio (NLCR), could be used as clinical markers of outcome in patients with bacteremia.MethodsWe performed a retrospective study of patients with a first episode of community-acquired or healthcare-related bacteremia during hospital admission between 2004 and 2009. A total of 2,311 patients were included. Cox regression was used to analyze the behaviour of eosinophil count and the NLCR in survivors and non-survivors.ResultsIn the adjusted analysis, the main independent risk factor for mortality was persistence of an eosinophil count below 0.0454·103/uL (HR = 4.20; 95% CI 2.66–6.62). An NLCR value >7 was also an independent risk factor but was of lesser importance. The mean eosinophil count in survivors showed a tendency to increase rapidly and to achieve normal values between the second and third day. In these patients, the NLCR was <7 between the second and third day.ConclusionBoth sustained eosinopenia and persistence of an NLCR >7 were independent markers of mortality in patients with bacteremia.

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Section: Discussionmentioning

confidence: 99%

“…This author also suggested that an increase in eosinophils could indicate that recovery had begun. Several studies have used eosinophil counts, specifically eosinopenia, as a marker of infection [4]–[8] and as an indicator of bacteremia [9]–[11], although the results are controversial.…”

Section: Introductionmentioning

confidence: 99%

Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

et al. 2012

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“…While the most acceptable cutoff for the eosinophil count in adults as a predictor of mortality is 40-50 cells/µL (10, 11, 20), our study suggested a lower level of 15 cells/µL in pediatric patients. This lower value can potentially be explained by either the greater vulnerability of children during severe inflammation and stress or the greater proportion of children who were medical, rather than surgical, ICU patients (medical vs surgical patients: 144 [95%] vs 6 [5%]) (21). …”

Section: Discussionmentioning

confidence: 99%

Prognostic Usefulness of Eosinopenia in the Pediatric Intensive Care Unit

et al. 2013

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Eosinopenia, a biomarker for infection, has recently been shown to be a predictor of adult mortality in the intensive care unit (ICU). Our study assessed the usefulness of eosinopenia as a mortality and an infection biomarker in the pediatric ICU (PICU). We compared the PICU mortality scores, eosinophil count and percentage at ICU admission between children who survived and those who did not survive and between children with infection and those without infection. A total of 150 patients were evaluated. The initial eosinophil count and percentage were significantly lower in the group that did not survive when compared to those that did survive (P < 0.001; P < 0.001). However, there was no significant difference in the eosinophil count and percentage seen in patients with and without infection. Eosinopenia, defined as an eosinophil count < 15 cells/µL and an eosinophil percentage < 0.25%, (hazard ratio [HR]: 2.96; P = 0.008) along with a Pediatric Index of Mortality (PIM) 2 (HR: 1.03; P = 0.004) were both determined to be independent predictors of mortality in the PICU. The presence of eosinopenia at the ICU admission can be a useful biomarker for mortality in children, but is not useful as a biomarker for infection.

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“…In the past decade, eosinopenia has aroused much attention in its diagnostic and prognostic values for bacterial infection and sepsis, with some studies showing promising results. [10-15, 17, 18, 24, 25] However, the results of currently available studies on the diagnostic performance of eosinopenia are quite different, which is manifested by a range of sensitivity from 23.2-92.5% and a range of speci city from 28.57-91% [9][10][11][12][13][14][15]. Therefore, we conducted a meta-analysis to integrate all results from different studies in order to get the pooled outcomes…”

Section: Discussionmentioning

confidence: 99%

“…The feasibility of eosinopenia in diagnosis of sepsis was rstly tested by Abidi et al, who showed that eosinopenia is good at discriminating between non-infection and infection, but is rather weak in differentiating sepsis from systemic in ammatory response syndrome (SIRS) [9]. Given that there is a signi cant correlation between sepsis and eosinopenia, several studies carried out in addressing the value of eosinopenia to diagnose sepsis recently [9][10][11][12][13][14][15] and to predict the prognosis of sepsis [16][17][18] with pretty much inconsistence. With emerging of new studies on eosinopenia as a marker of sepsis, we determine to perform the present meta-analysis to reevaluate whether eosinopenia is a good biomarker for diagnosis of sepsis.…”

Section: Introductionmentioning

confidence: 99%

Revisit Eosinopenia as a Biomarker for Diagnosis of Sepsis: A Meta-Analysis

Lin¹,

Rong²,

Zhang³

2020

Preprint

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BackgroundSepsis is a life-threatening and time-critical medical emergency, therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. So, we performed a meta-analysis to assess the diagnostic efficacy of eosinopenia for sepsis.MethodWe searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials CENTRAL databases to identify studies that met the inclusion criteria. Two authors performed data extraction independently. The pooled outcomes were calculated by TP (true positive), FP (false positive), FN (false negative), TN (true negative) by using bivariate meta-analysis model in STATA 14.0 software. ResultsSeven studies were included in the present study with a total number of 3842 subjects. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.66 (95%CI [0.53-0.77]), 0.68 (95%CI [0.56-0.79]), 2.09 (95%CI [1.44-3.02]), 0.49 (95%CI [0.34-0.71]) and 4.23 (95%CI [2.15-8.31]), respectively. The area under the summary receiver operator characteristic curve (SROC) was 0.73 (95%CI [0.68-0.76]). Meta-regression analysis revealed that no single parameter accounted for the heterogeneity of pooled outcomes. For each subgroup of different eosinopenia cutoff values (50, 40, <=25, 100), the sensitivity was 0.61, 0.79, 0.57, 0.54, and the specificity was 0.61, 0.75, 0.83, 0.51, respectively. ConclusionsOur findings suggest that eosinopenia shows no superiority in the diagnosis of sepsis. Further large clinical trials are needed to re-evaluate eosinopenia as a biomarker of sepsis.

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Evaluación de la eosinopenia como marcador de infección en pacientes ingresados en una Unidad de Cuidados Intensivos

Abstract: In a medical-surgical ICU, the capacity to discriminate infection through examining eosinopenia is not high. It could be useful to rule out infection if we combined eosinopenia with monocytes count.

Cited by 11 publications

References 29 publications

Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

Prognostic Usefulness of Eosinopenia in the Pediatric Intensive Care Unit

Revisit Eosinopenia as a Biomarker for Diagnosis of Sepsis: A Meta-Analysis

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Evaluación de la eosinopenia como marcador de infección en pacientes ingresados en una Unidad de Cuidados Intensivos

Abstract: In a medical-surgical ICU, the capacity to discriminate infection through examining eosinopenia is not high. It could be useful to rule out infection if we combined eosinopenia with monocytes count.

Cited by 11 publications

References 29 publications

Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

Eosinophil Count and Neutrophil-Lymphocyte Count Ratio as Prognostic Markers in Patients with Bacteremia: A Retrospective Cohort Study

Prognostic Usefulness of Eosinopenia in the Pediatric Intensive Care Unit

­Revisit Eosinopenia as a Biomarker for Diagnosis of Sepsis: A Meta-Analysis

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Revisit Eosinopenia as a Biomarker for Diagnosis of Sepsis: A Meta-Analysis