Eosinophils are an acute event during the course of chronic obstructive pulmonary disease (COPD), and their elevation is significantly associated with the clinical outcome of COPD patients, by predicting worsening clinical symptoms, deteriorating lung function, and increased mortality. Identification of a simple and reliable biomarker can evaluate... The risk of adverse outcomes during hospitalization for COPD is critical to patient management and rational allocation of medical resources, so our study was to determine the role that peripheral blood eosinophil count can play in predicting short-term (in-hospital) outcomes for patients admitted with a diagnosis of COPD. COPD), depending on lung function.
The results of our study revealed that death in hospital occurred in (18%) of patients with obstructive pulmonary disease (COPD). Although there was no difference in the distribution of males and females according to the case of death in hospital, the rate of in-hospital mortality was higher in older patients, but in In our study, there was no significant increase in the number of eosinophils, as the percentage of patients who had an increase in eosinophils reached more than 300 (10.9%) of patients.
Whereas patients who required admission to intensive care had a higher average eosinophil count, higher eosinophils did not increase the need for admission to intensive care, as the relative risk is small and the confidence interval is 95% without statistical significance (P = 0.331).
Whereas patients who required mechanical ventilation had a higher average eosinophil count, higher eosinophils did not increase the need for mechanical ventilation, as the relative risk was small and the confidence interval was 95% without statistical significance (P = 0.122).
The average duration of hospital stay for patients with obstructive pulmonary disease with blood eosinophils less than 300 cells was 5.5 ± 2.1 days, while for patients with blood eosinophils greater than 300 cells it was 7.2 ± 2.3 days. Comparing the average length of hospital stay according to the value of blood eosinophils, this result is consistent with With all of the study
The average length of hospital stay in patients with obstructive pulmonary disease with an eosinophil count greater than 300 was statistically significantly greater than in patients without elevated blood eosinophils (P = 0.001).
According to what is published in the medical literature, in-hospital deaths resulting from COPD range from 2 to 22.2% (14), and the in-hospital mortality rate among our patients is within the aforementioned global range.
Regarding inflammatory markers, many previous studies also revealed that the serum level of systemic inflammatory markers in COPD patients was higher than that of healthy controls. In fact, studies also showed that COPD patients (even in a stable state) had a higher percentage. of C-reactive protein, elevated eosinophils, fibrinogen, interleukin-6, and tumor necrosis factor-a compared to healthy controls. High levels of the aforementioned inflammatory markers are associated with an increased risk of severe exacerbations and an increased risk of mortality (15).
Our study was consistent with the study of (Yao et al) (69), in China in 2017, which is a retrospective study that included 303 patients admitted for COPD. Hospital death occurred in 12.2% of patients, as the average eosinophils in hospital deaths Higher by a statistically significant difference compared to surviving patients.
In a study consistent with our study conducted in Colombia in 2021 by (Comez - Rosero et al) (16), which is a cohort study that included 610 patients admitted to hospital due to COPD, 15% of patients were admitted to the intensive care unit, and death occurred in 3.19% of patients. The average eosinophil count among patients admitted to hospital was higher among patients admitted to care, with a statistically significant difference compared to patients who were not admitted to care.
The study of Teng et al (17) reached the same conclusion, as high eosinophils were an independent risk factor for admission to the intensive care unit in patients with COPD, while the study of Aksoy et al (18) found that it could predict the location of treatment for COPD. ) through the eosinophil value upon review, as patients with eosinophil values less than 300 can be treated as outpatients without hospitalization, but the rest of the inflammatory markers and other values must also be taken into account. They recommended treating patients with eosinophil levels higher than 500–1500 cells in the hospital ward. Patients with eosinophil counts higher than this were recommended to be admitted to the intensive care unit.