IMPACT OF SERUM EOSINOPHIL COUNTS ON HOSPITAL LENGTH OF STAY, READMISSION RATES, AND IN-HOSPITAL OUTCOMES IN PATIENTS WITH ACUTE EXACERBATION OF COPD

Abstract

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To assess whether serum eosinophilia increases hospital lengths of stay, readmission rates, intubation rates, and intensive care unit (ICU) admission. METHODS: This was an observational retrospective study design. We analyzed data of patients admitted for acute exacerbation of COPD (AE-COPD) between January 2011 and December 2018. Patients were stratified into high eosinophil group if the blood eosinophil count at admission was ≥2% of the total white blood cells or ≥150cells/µL. Inclusion criteria included spirometry showing FEV1/FVC ratios less than 70%, age over 40 years, and smoking history. The study was approved by the University of Missouri Institutional Review Board. RESULTS: A total of 87 patients were included in the analysis. The average age was 62 years (SD 8.95) and 57% of patients were female. The average length of stay was 4 days (SD 3.94 days). There were 16 (18%) patients with eosinophils greater than 2% and 25 (29%) patients with eosinophils greater than 150 cells/µL. The average FEV1 was 1.42L (SD 0.55L). There were 15 patients (17%) who were readmitted within 1 year. There was no difference in readmission rates between the low eosinophil group compared to the high eosinophil group (OR, 0.582; 95% CI, 0.118–2.86; P =0.725). There was also no statistically significant difference in lengths of stay between the two groups (4.23 days vs 2.56, p =0.128). There was no difference in the intubation rates (OR 0.88; 95% CI 0.096-8.09; p=.91) or ICU admission rates (OR 0.85; 95% CI 0.245-2.95 p=.798). Serum eosinophil counts decreased from admission to discharge. Inhaled corticosteroid (ICS) use prior to admission did not influence eosinophil levels. CONCLUSIONS: Peripheral eosinophilia (>2% of total white cell count) at time of admission in patients presenting with AE-COPD does not appear to have a significant impact on ICU admission, intubation, hospital LOS, or readmission. Our data is limited by a small sample size. CLINICAL IMPLICATIONS: More clinical research is required to determine the accuracy and usefulness of eosinophils as a biomarker for outcomes in patients with acute exacerbations of COPD. There is continued need to search for other biomarkers to help us better define the risk of COPD exacerbation. This is especially important in determining patients who may be at higher risk for intubation and ICU admission. DISCLOSURES: No relevant relationships by Trent Bailey, source=Web Response No relevant relationships by karthik Gangu, source=Web Response No relevant relationships by Armin Krvavac, source=Web Response No relevant relationships by Tinashe Maduke, source=Web Response No relevant relationships by Pooja Nair, source=Web Response No relevant relationships by Sara Tepe, source=Web Response