Prevalence of eosinophilia in hospitalized patients with asthma exacerbation

Hasegawa, Kohei; Stoll, Samantha J.; Ahn, Jason; Bittner, Jane C.; Camargo, Carlos A.

doi:10.1016/j.rmed.2015.07.011

Cited by 23 publications

(19 citation statements)

References 15 publications

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“…Nevertheless, we found a significant inverse association between eosinophil count and risk of admission. This finding differs from those of the pilot study by Hasegawa et al [44], who found that, of 80 patients hospitalized for asthma exacerbation, 32 patients (40%) had blood eosinophilia (300/mm 3 ). However, the study was limited by the inclusion of patients with severe acute asthma in the analytic cohort population, which may suggest that their study population was in poorer health than the overall population of patients hospitalized for asthma exacerbation.…”

Section: Discussioncontrasting

confidence: 99%

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Pola-Bibian¹,

Domínguez‐Ortega²,

Vilà-Nadal³

et al. 2017

J Investig Allergol Clin Immunol

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Background: The risk factors for asthma exacerbations are not fully understood. The aim of this study was to determine the epidemiological and clinical characteristics of patients who experience asthma exacerbations. We also assessed potential triggers of exacerbations and possible predictors of hospitalization. Methods: A retrospective, noninterventional cohort study was conducted in adult patients who attended the emergency department of a tertiary hospital with an asthma exacerbation during 2014.

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Section: Discussioncontrasting

confidence: 99%

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Pola-Bibian¹,

Domínguez‐Ortega²,

Vilà-Nadal³

et al. 2017

J Investig Allergol Clin Immunol

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“…The primary outcome was prevalence of blood eosinophilia. Based on the literature, eosinophilia was defined as an absolute eosinophil count ≥300 cells/μL in peripheral blood on the first‐measured cell counts with differentials during the in‐hospital course (including pre‐hospitalization emergency department/clinic visit). Additionally, based on the other COPD studies, we also used an alternative cut‐off of ≥2% of total white cell count in peripheral blood.…”

Section: Characteristics and Outcomes Of Patients Hospitalized For Acmentioning

confidence: 99%

Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD

Hasegawa

Camargo

2015

Respirology

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In this cohort of 3084 patients hospitalized for acute exacerbation of COPD (AECOPD), we found that 17% had blood eosinophilia (≥300 cells/μL); the use of an alternative cut-off level (≥2%) demonstrated that 40% had elevated eosinophil count. Patients with eosinophilia had higher frequency of readmission for AECOPD during 1-year follow-up period. This is the first study to investigate the prevalence of eosinophilia among inpatients with AECOPD-the population with the highest morbidity and health-care utilization.

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“…A small pilot study from Japan (n = 47) did not find any differences among patients hospitalized for asthma exacerbation in initial vital signs, requirement for ventilatory support or disposition between those with eosinophils ≥0.3 × 10 9 /L compared with those with eosinophils <0.3 × 10 9 /L, but the study was underpowered. 30 A study of 1316 patients admitted with non-life threatening exacerbations reported that an eosinophil count of ≥0.4 × 10 9 cells/L was associated with a reduction in late Step 5 readmission risk of 41% and a decrease in frequent late readmission of 63%. 31 An important limitation in many of these studies is the arbitrary selection of eosinophil count thresholds which were presumably extrapolated from studies evaluating blood eosinophil count as a pharmacodynamic biomarker of response to biologics, for example, ≥0.150 or 0.300 × 10 9 /L for mepolizumab, ≥0.300 × 10 9 /L for benralizumab and ≥0.400 × 10 9 /L for reslizumab.…”

Section: Discussionmentioning

confidence: 99%

Blood eosinophil count correlates with severity of respiratory failure in life‐threatening asthma and predicts risk of subsequent exacerbations

Yii

Tay

Puah

et al. 2019

Clin Experimental Allergy

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Background An elevated blood eosinophil count when asthma is stable predicts exacerbations and therapeutic response to corticosteroids or biologics targeting eosinophils. Few studies have examined the prognostic value of blood eosinophils measured at exacerbation. Aim To elucidate the relationship between a spot blood eosinophil count–measured at the onset of a life‐threatening asthma exacerbation–with indices of exacerbation severity and risk of subsequent exacerbations. Methods Real‐world, retrospective review of all life‐threatening asthma cases admitted at 4 public hospitals in Singapore between 2011‐2015. We assessed the trends and correlations between blood eosinophil count on admission with arterial blood gas values, duration of mechanical ventilation, and risk of death, hypoxic ischemic encephalopathy or respiratory arrest. Risk of future exacerbations among survivors was modelled using Cox regression and survival curves. Results There were 376 index life‐threatening exacerbations with median blood eosinophil count (5‐95th percentiles) of 0.270 × 109/L (0‐1.410 × 109/L). Arterial pH decreased and PCO2 increased with increasing eosinophil count. Duration of mechanical ventilation and risk of death, hypoxic ischaemic encephalopathy or respiratory arrest did not vary with eosinophils. Among 329 survivors who were followed‐up over a median of 52 months, blood eosinophils ≥1.200 × 109/L was associated with an increased hazard of emergency visits and/or admissions for asthma (hazard ratio 1.8, 95% confidence interval 1.1‐2.9, P = .02). Conclusion In this study of life‐threatening asthma, we found that a spot blood eosinophil count correlates with severity of respiratory failure and predicts risk of subsequent exacerbations.

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Prevalence of eosinophilia in hospitalized patients with asthma exacerbation

Abstract: Our pilot study showed that 40% of patients hospitalized for asthma exacerbation had eosinophilia. The clinical meaning of this biomarker in the emergency department/inpatient setting requires further study in much larger samples with long-term follow-up; such studies appear feasible.

Cited by 23 publications

References 15 publications

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Asthma exacerbations in a tertiary hospital: clinical features, triggers, and risk factors for hospitalization

Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD

Blood eosinophil count correlates with severity of respiratory failure in life‐threatening asthma and predicts risk of subsequent exacerbations

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