Prognostic Usefulness of Eosinopenia in the Pediatric Intensive Care Unit

Abstract

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.

Eosinophil count at intensive care unit admission was not predictor of hospital mortality: results of a case control study

“…We did not find an association between eosinophil count at ICU admission and hospital mortality, this contrast with that reported by other authors [10, 12, 30]. The retrospective design of our study, including an unselected population of critically ill patients and increased frequency of sepsis in the group of non-survivors, could explain this difference.…”

Comparison of the Eosinophil Count to C –reactive protein, Leukocyte Count, and Neutrophil Count for the detection of bacterial infection in ill-appearing children with fever admitted to the Emergency Department

“…Another study found no significant difference in the eosinophil count and percentage in children with and without infection in the pediatric ICU. (19) As seen above, the most important difference from literature is our work done in ill-appearing children in emergency department. Therefore, the comparing of our results with the literature is not easy.…”

“…(18,19) We found that a low blood eosinophil count (≤ 50 cells/mm 3 ) is similar to a high CRP level (≥1.22 mg/dL) and a high neutrophil count (>5100 cells/mm 3 ) for predicting bacterial infection in the pediatric emergency department. However, none of them had sufficient discriminatory power.…”

C-Reactive Protein and Hemogram Parameters for the Non-Sepsis Systemic Inflammatory Response Syndrome and Sepsis: What Do They Mean?

“…Hence, hemogram parameters which are inexpensive laboratory tests can be helpful for diagnosis of sepsis. Although WBC C was indicated as a sepsis criteria in the last guideline, some studies have demonstrated that it has low sensitivity and specificity for sepsis diagnosis [ 8 , 9 ]. Neutrophil count (Neu C ) and eosinophil count (Eo C ) were used as a predictor of sepsis in the early 1990s [ 9 – 13 ].…”