Role of peripheral eosinophilia in acute exacerbation of chronic obstructive pulmonary disease

Link to article at PubMed

World J Clin Cases. 2020 Jul 6;8(13):2727-2737. doi: 10.12998/wjcc.v8.i13.2727.


BACKGROUND: Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease (COPD).

AIM: To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD (AECOPD).

METHODS: From January 2014 to May 2017, patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count: The EOS group (eosinophil count ≥ 2%) and the non-EOS group (eosinophil count < 2%). Demographics, comorbidities, laboratory data, steroid use, length of hospital stay, and COPD-related readmissions were compared between the groups.

RESULTS: A total of 625 patients were recruited, with 176 patients (28.2%) in the EOS group. The EOS group showed a lower prevalence of infection, lower cumulative doses of prednisolone equivalents, shorter length of hospital stay, and higher number of COPD-related readmissions than the non-EOS group. There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay (P < 0.001, Pearson's r = 0.147; P = 0.031, Pearson's r = -0.086, respectively). The EOS group and a lower percent-predicted value of forced expiratory volume in one second (FEV1) were associated with shorter time to first COPD-related readmission [adjusted hazard ratio (adj. HR) = 1.488, P < 0.001; adj. HR = 0.985, P < 0.001, respectively].

CONCLUSION: The study findings suggest that the EOS group had the features of a shorter length of hospital stay, and lower doses of systemic steroids, but more frequent readmissions. The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.

PMID:32742983 | PMC:PMC7360705 | DOI:10.12998/wjcc.v8.i13.2727

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