Eosinopenia as a marker of mortality and length of stay in patients admitted with exacerbations of chronic obstructive pulmonary disease
Eosinopenia as a marker of mortality and length of stay in patients admitted with exacerbations of chronic obstructive pulmonary disease
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DOI：
10.1111/j.1440-1843.2009.01651.x
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发表时间：
2010-01-01
期刊：
影响因子：
6.9
通讯作者：
Babores, Marta
中科院分区：
文献类型：
--
作者：
Holland, Mat;Alkhalil, Mohammad;Babores, Marta
背景与目的：长期以来，血液中嗜酸性粒细胞减少一直被认为是急性感染的标志，最近在危重患者中被证明是比CRP更好的脓毒症预测指标。本研究以住院死亡率和住院时间作为严重程度的指标，探讨了红细胞减少（< 0.04）对预测COPD恶化严重程度的有用性。方法：回顾性分析2007年3月至2008年4月住院的慢性阻塞性肺病加重患者的病例记录。排除有肺炎影像学证据的患者和前一周服用类固醇的患者。收集年龄、住院时间、pH、WCC和死亡率的数据。结果：65例患者符合纳入标准，其中嗜酸性粒细胞计数正常42例，嗜酸性粒细胞减少23例。两组患者的年龄、总WCC和入院ph无显著差异。然而，与嗜酸性粒细胞正常组相比，嗜酸性粒细胞减少组的死亡率(4/23 （17.4%)vs 1/42 (2.4%), P = 0.049）和住院时间（8天vs 5天，P = 0.005）有显著差异。结论：嗜酸性粒细胞计数可能是入院的COPD加重患者的一个有用的严重程度标志，独立于WCC和ph。因为它是所有入院患者的常规全血细胞计数，所以这项有益的测试不需要额外的费用。
Background and objective:Blood eosinopenia has long been known as a marker of acute infection, and has recently been shown to be a better predictor of sepsis than CRP in critically ill patients. This study examines the usefulness of eosinopenia (< 0.04), for predicting the severity of exacerbations of COPD using inpatient mortality and length of stay as markers of severity.Methods:Retrospective review of the case-notes of patients admitted with an exacerbation of COPD from March 2007 to April 2008. Patients with radiographic evidence of pneumonia and those having steroids in the previous week were excluded. Data were collected for age, length of stay, pH, WCC and mortality.Results:Sixty-five patients fulfilled the inclusion criteria, 42 with a normal eosinophil count and 23 with eosinopenia. No significant differences were seen between the two groups' age, total WCC and admission pH. However, significant differences were seen in mortality (4/23 (17.4%) vs 1/42 (2.4%), P = 0.049) and length of stay (8 vs 5 days, P = 0.005) when the eosinopenia group compared with those with normal eosinophils.Conclusions:The eosinophil count might be a useful marker of severity inpatients admitted with an exacerbation of COPD independent of the WCC and pH. As it is routinely given in the full blood count in all patients admitted to hospital, there is no extra cost for this beneficial test.