Abstract
ObjectivesThis study aimed to evaluate the prevalence and clinical significance of elevated peripheral blood eosinophil (PBE) counts in hospitalised patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Oman. An elevated PBE count during AECOPD is a potential predictor of treatment responsiveness and future exacerbation risk.MethodsThis single-centre retrospective study included all patients with AECOPD who were admitted to Sultan Qaboos University Hospital, Muscat, Oman, between January 2017 and July 2019. The patients were classified as having eosinophilic or non-eosinophilic 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.ResultsOf 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 groups were treated with inhaled and oral steroids. The need for mechanical ventilation did not differ between the groups.ConclusionEosinophilia 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.
Highlights
Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation
Eosinophilia is highly prevalent in patients with Acute exacerbation of chronic obstructive pulmonary disease (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
Summary
Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation. Several studies have shown that patients with elevated PBE counts are at an increased risk of frequent exacerbations but show a good response to steroid therapy.[1, 4]. Evidence suggests that circulating eosinophils can be recruited to the lungs and can increase inflammation by the actions of cytokines, immunoregulatory cells, and other proinflammatory mediators.[7] PBE count has been suggested to be useful as a surrogate marker to direct the use of oral steroid therapy in patients with AECOPD and as a predictor of future exacerbation and disease stability.[6] The data assessing the role of PBE on mortality outcome are inconsistent.[8, 9] Overall, the role of PBEs in the clinical manifestation of COPD remains highly debatable.[10, 11] No prior study has been conducted in the Middle
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
