The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia [Corrigendum]

Duman, Dildar; Aksoy, Emine; Ağca, Meltem; Koçak, Nagihan Durmuş; Özmen, İpek; Aktürk, Ülkü Aka; Güngör, Sinem; Tepetam, Fatma Merve; Eroğlu, Selma; Oztas, Selahattin; Karakurt, Zühal

doi:10.2147/copd.s103721

Cited by 5 publications

(5 citation statements)

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“…The impact of blood eosinophil levels on readmission rates is an ongoing research question: some studies showed increased readmissions;21–23 others did not find significant effect;19 and another study found negative association between readmissions and eosinophilic exacerbations 24. Among these conflicting results, Couillard et al21 argued that a potential confounding factor might be the timing of corticosteroid administration, which could have masked peripheral eosinophilia.…”

Section: Introductionmentioning

confidence: 99%

<p>Greater eosinophil counts at first COPD hospitalization are associated with more readmissions and fewer deaths</p>

Larivée

Courteau

et al. 2019

COPD

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The impacts of high blood eosinophil count (HBEC) at admission for COPD exacerbation on posthospitalization outcomes are still unclear. Previous studies have focused on its associations with first readmission rates; yet, its impacts on longitudinal outcomes such as subsequent readmissions still have to be explored. The main objective of this study is to investigate outcomes associated with HBEC following a first hospitalization for COPD exacerbation. Patients and methods: This is an observational cohort study design. We retrospectively analyzed data of patients with a first hospitalization within 5 years for COPD exacerbation between April 2006 and March 2013. Patients were stratified into the HBEC group if the blood eosinophil count at admission was 200 cells/µL and/or 2% of the total white blood cells. With information on exact dates of subsequent hospitalizations and death, we modeled readmissions and death as states in a multi-state Markov model and estimated transition probabilities to the next states. Sensitivity analyses were performed by varying thresholds for the definition of HBEC (300 cells/µL and/or 3%). Results: A total of 479 patients were included, of which 173 had HBEC. The transition probabilities for a first readmission was 74% (95% CI, 66%-83%) for patients with HBEC vs 70% (95% CI, 63%-77%) for patients with normal blood eosinophil count (NBEC). The transition probabilities for a second readmission were 91% (95% CI, 84%-100%) for HBEC patients in contrast with 83% (95% CI, 74%-92%) for NBEC patients. Meanwhile, transition probability for death was lower in patients with HBEC. The differences enlarged in sensitivity analyses with higher cutoff. Conclusion: Greater blood eosinophil cell counts during a first hospitalization for COPD predict increased susceptibility to up to two readmissions. These patients may however have a lower risk of death.

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Section: Introductionmentioning

confidence: 99%

<p>Greater eosinophil counts at first COPD hospitalization are associated with more readmissions and fewer deaths</p>

Larivée

Courteau

et al. 2019

COPD

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“…As a biomarker for AECOPD risk and treatment response, peripheral blood eosinophil level is being monitored. Recent studies 15 – 17 show that systemic steroid treatment improves COPD exacerbation symptoms faster. Corticosteroid treatment was more effective when there was peripheral blood eosinophilia (2%).…”

Section: Discussionmentioning

confidence: 99%

“…In 4 studies on eosinophilic AECOPD, corticosteroid treatment had a better treatment response, and also intensive care and ward hospitalization rates were lower, noninvasive mechanical ventilation response was better. 15 , 24 , 27 In the current study, ICU-admitted AECOPD patients were excluded. Bafadhel et al 28 evaluated peripheral blood eosinophilia in AECOPD.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Kabil¹,

Karakurt²,

Gundogus³

et al. 2023

Thoracic Research and Practice

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Objective: The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pulmonary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil–lymphocyte ratio and peripheral blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary diseases. This would reduce the rate of re-hospitalization in 28 days. Material and Methods: Patients were hospitalized due to acute exacerbation of chronic obstructive pulmonary diseases from February 1, 2018, to January 31, 2019. Patients were divided into 2 groups: Sureyyapasa protocol group and conventional group. In the Sureyyapasa protocol group, patients were divided into 4 subgroups according to peripheral blood eosinophilia and neutrophil–lymphocyte ratio values. Treatment success was defined as 5-7 days acute exacerbation of chronic obstructive pulmonary diseases treatment was enough to discharge and no re-hospitalization within 28 days. Treatment failure was defined that the hospital stay was longer than 7 days or transport to intensive care and death or readmission to the hospital due to acute exacerbation of chronic obstructive pulmonary diseases within 28 days after discharge. Results: The Sureyyapasa protocol group (n = 96) and the conventional group (n = 95) were randomly selected. The conventional group and Sureyyapasa protocol group had similar hospital stay ( P = .22), and antibiotic and steroid uses were significantly higher in the conventional group than the Sureyyapasa protocol group (antibiotic use 100% vs. 83%, P < .001 and steroid use 84% vs. 29%, P < .001, respectively). Treatment failure in the conventional Group (n = 23, 24%) is higher than the Sureyyapasa protocol group (n = 17, 18%). Conclusions: Initiating treatment by evaluating eosinophilia and neutrophil–lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary diseases in the ward reduces unnecessary antibiotic and steroid use and cost rates in hospitalizations.

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“…The prevalence of eosinophilic AECOPD ranged from 10% to 37% in previous studies. [13][14][15] These differences in the prevalence of eosinophilia during AECOPD could be explained by the difference in patients' ethnicity, use of corticosteroids before admission, and difference in cut-off values used to define eosinophilia. 1, [16][17][18] The most commonly used cut-off value to define eosinophilic COPD is 2%, which corresponds to 150 cells/μL.…”

Section: Discussionmentioning

confidence: 99%

Elevated Peripheral Blood Eosinophils during Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Sibani

Alawi

Aghbari

2022

Sultan Qaboos Univ Med J

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Objectives: An elevated peripheral blood eosinophil (PBE) count during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a potential predictor of treatment responsiveness and future exacerbation risk. This study aimed to evaluate the prevalence and clinical significance of elevated PBE counts in hospitalized patients with AECOPD in Oman. Methods: This single-center retrospective study included all patients with AECOPD who were admitted to Sultan Qaboos University Hospital between January 2017 and July 2019. The patients were classified as having eosinophilic or noneosinophilic AECOPD based on blood eosinophil counts. An elevated eosinophil count was defined as a blood eosinophil count > 0.3 × 109 cells/L on admission. The length of hospital stay, use of oral and inhaled steroids, number of readmissions in a year, and use of mechanical ventilation on admission were compared between the eosinophilic and non-eosinophilic AECOPD groups. Results: Of the 102 patients included in the study, 42.2% had eosinophilic AECOPD. The eosinophilic AECOPD group had a reduced length of hospital stay (P = 0.02) but an increased risk of readmission in a year (P = 0.04). Most patients in both the groups were treated with inhaled and oral steroids. The need for mechanical ventilation did not differ between the groups. Conclusion: Eosinophilia is highly prevalent in patients with AECOPD and is associated with a reduced length of hospital stay but an increased risk of readmission in a year. It can be used as a surrogate marker to predict the health outcomes of patients with AECOPD and select treatment options. Keywords: Chronic Obstructive Pulmonary disease (COPD); Eosinophils; Steroids; length of stay; hospital readmission.

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The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia [Corrigendum]

Cited by 5 publications

References 0 publications

<p>Greater eosinophil counts at first COPD hospitalization are associated with more readmissions and fewer deaths</p>

<p>Greater eosinophil counts at first COPD hospitalization are associated with more readmissions and fewer deaths</p>

Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Elevated Peripheral Blood Eosinophils during Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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