Eosinopenia as a marker of outcome in acute exacerbation of chronic obstructive pulmonary disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the world.Acute exacerbation of COPD has 10% mortality rate at admission and 1/3rd die within a year of hospitalization. Eosinopenia typically accompanies the response to acute inflammation or infection. The objective of this study was to know whether eosinopenia is an economical marker in predicting the outcome in patients hospitalized due to acute exacerbation of COPD.Methods: This is a prospective study conducted on 121 patients presenting with AECOPD satisfying inclusion and exclusion criteria admitted in hospitals attached to Bangalore Medical College and Research Institute. All necessary investigations were done. Patients with AECOPD were divided in two groups: One with eosinopenia and other without eosinopenia. Duration of hospitalization, need for mechanical ventilation and in-hospital mortality was assessed in both the groups. Results: Among 121 patients with AECOPD, 56 were eosinopenic and 65 patients were non-eosinopenic. Majority of patients belonged to age group of 51-60 years with mean age was 62.06±10.783 years. Duration of hospitalization of patients with eosinopenia was 9.04±5.18 days and that of patients without eosinopenia was 6.15±2.89 (p value<0.001). Among them, 41 (73.2%) patients with eosinopenia and 21 (32.3%) patients without eosinopenia needed mechanical ventilation (p≤0.001). In-hospital mortality rates among eosinopenic and non-eosinopenic patients were 53.6% and 15.4% respectively. Conclusions: There is a significant relationship between eosinopenia and outcomes of patients with AECOPD. Thus, eosinopenia is a useful, easy-to-measure, inexpensive biomarker for predicting the prognosis and outcome in patients with AECOPD.

DECAF score at admission as a tool to predict clinical outcome in acute exacerbation of COPD

“…Out of 200 patients, the total in-hospital mortality is 10.5% in our study population. The in-hospital mortality in the study conducted by Steer et al is 10.43%, 11 which is similar to our study. In a study reported by Huang et al, the DECAF score is an effective and possible predictor for short-term mortality.…”

“…Acidemia is slightly higher than in other studies, ranging from 19% to 20%. 11,12 The prevalence of atrial fibrillation in our population was 4.0%, and this was lower than that presented in the study by Steer et al 10 The overall mortality in each group by DECAF score was 0%, 7.4%, and 38.6%. This is similar to previous studies that reported that mortality was 1.4% in low-risk patients, 8.4% in the intermediate-risk group, and 34.6 % in highrisk patients.…”

“…Similarly, in a Biradar et al study, eosinopenia patients showed poor outcomes of long-duration hospital stays, increased need for mechanical ventilation, and higher mortality risk. 11 Consolidation was found to be present in 29.5% of the study population.…”