Blood Eosinophils and Clinical Outcome of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Link to article at PubMed

Respiration. 2020 Dec 29:1-10. doi: 10.1159/000510516. Online ahead of print.


BACKGROUND: Numerous studies have shown the association between eosinophilia and clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). But the evidences are lack of consensus.

OBJECTIVE: The aim of this meta-analysis was to conduct a pooled analysis of outcome comparing eosinophilic (EOS) AECOPD and non-EOS AECOPD patients.

METHODS: We included PubMed, EMBASE, Web of Science, and Cochrane databases up to 2020 to retrieve articles. Randomized controlled trials and quasi-experimental studies about patients with and without EOS AECOPD in terms of in-hospital mortality, length of hospital stay, comorbidities, forced expiratory volume in 1 s (FEV1), gender, and BMI were included preclinical studies, review articles, editorials, commentaries, conference abstracts, and book chapters were excluded. The methodologic assessment of studies was performed with the Newcastle-Ottawa Scale and Cochran scale. Comprehensive Rev Man 5 was used for the statistical analysis.

RESULTS: Twenty-one studies with 18,041 patients fulfilled the inclusion criteria and were used in this meta-analysis. Comparing to the non-EOS group, those with EOS AECOPD patients had a lower risk for in-hospital mortality (odds ratio (OR) = 0.59, 95% confidence interval [CI] 0.36-0.95, p = 0.03), shorter length of hospital stay (OR = -0.72, 95% CI -1.44 to -0.00, p = 0.05), better FEV1 (mean difference = 0.14, 95% CI 0.08-0.20, p < 0.00001), and a lower risk of arrhythmias (OR = 1.50, 95% CI 1.01-2.21, p = 0.04). In addition, the non-EOS group had a higher percentage of male (OR = 1.34, 95% CI 1.15-1.56, p = 0.0002) than EOS group. The rate of steroid use (OR = 0.82, 95% CI 0.47-1.42, p = 0.48) and BMI (mean difference = 0.43, 95% CI -0.18 to 1.05, p = 0.17] had no difference between 2 groups.

CONCLUSION: The results of our meta-analysis suggest that EOS AECOPD patients have a better clinical outcome than non-EOS AECOPD patients in terms of length of hospital stay, in-hospital mortality, FEV1, and risk of arrhythmias. In addition, the non-EOS AECOPD patients have higher percentage of male than EOS AECOPD patients.

PMID:33373986 | DOI:10.1159/000510516

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