Prognostic role of blood eosinophils in acute exacerbations of chronic obstructive pulmonary disease: systematic review and meta-analysis

Monaldi Archives for Chest Disease, Год журнала: 2025, Номер unknown

Опубликована: Март 27, 2025

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause hospitalization and mortality worldwide. While blood eosinophils have been suggested as prognostic biomarker COPD, their predictive value in AECOPD remains uncertain. This meta-analysis aims to evaluate the role eosinophil counts predicting hospital readmission these patients. A systematic review were conducted according PRISMA guidelines. We included studies that evaluated AECOPD, with predefined cut-offs. Data on rates extracted, statistical analyses performed assess sensitivity, specificity, likelihood ratios. total 14 23,625 patients included. High during had low sensitivity (28.1%) specificity (66.2%) 12-month readmission. Positive negative ratios also suboptimal, values 0.8 1.1, respectively. Sensitivity analyses, including only high-quality studies, confirmed findings. The results suggest limited variability cut-offs lack consistent data across contribute this limitation. Further large-scale prospective are needed clarify marker AECOPD. Consequently, routine measurement acute exacerbations may not be warranted for purposes.

Язык: Английский

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Implication of Admission Eosinophil Count and Prognosis of Coronavirus Disease 2019 (COVID‐19) in Elderly Patients With COPD: A Territory‐Wide Cohort Study

The Clinical Respiratory Journal, Год журнала: 2025, Номер 19(4)

Опубликована: Март 27, 2025

This study aims to investigate the association between elderly patients with COPD different blood eosinophil on admission and those without prognosis of COVID-19. A territory-wide retrospective was conducted Elderly admitted public hospitals community treatment facility in Hong Kong for COVID-19 from January 23, 2020, September 31, 2021, were included study. Severe diseases defined as who develop respiratory complications, systemic complications death. Among 1925 included, 133 had COPD. Forty count ≥ 150 cells/μL, 93 < cells/μL. Patients but not severe development complications. They more likely failure (OR = 5.235, 95% CI 2.088-13.122, p 0.001) require invasive mechanical ventilation 2.433, 1.022-5.791, 0.045) intensive care unit 2.214, 1.004-4.881, 0.049). Our suggested that could have significant prognostic implications among significantly increased risks developing COVID-19, when compared non-COPD patients.

Язык: Английский

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Predictors of Readmission, for Patients with Chronic Obstructive Pulmonary Disease (COPD) – A Systematic Review

International Journal of COPD, Год журнала: 2023, Номер Volume 18, С. 2581 - 2617

Опубликована: Ноя. 1, 2023

Introduction: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally and responsible for over 3 million deaths annually. One factors contributing to significant healthcare burden these patients readmission. The aim this review describe predictors prediction scores all-cause COPD-related readmission among with COPD. Methods: A search was conducted in Ovid MEDLINE, Embase, Cochrane Database Systematic Reviews, Central Register Controlled Trials, from database inception June 7, 2022. Studies were included if they reported on at least 40 years old COPD, data within 1 year, Study quality assessed. Significant degree significance, as noted by p -value, extracted each study. This registered PROSPERO (CRD42022337035). Results: In total, 242 articles reporting 16,471,096 included. There a low risk bias across literature. Of these, 153 studies observational, predictors; 57 observational interventions; 32 randomized controlled trials interventions. Sixty-four 23 1) pre-admission patient characteristics, such male sex, prior hospitalization, poor performance status, number type comorbidities, use long-term oxygen; 2) hospitalization details, length stay, corticosteroids, ventilatory support; 3) results investigations, including anemia, lower FEV , higher eosinophil count; 4) discharge home oxygen care or skilled nursing facility. Conclusion: findings may enable better predictive modeling can be used clinicians inform their clinical gestalt risk. Keywords: predictors, readmission, chronic

Язык: Английский

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The association between blood eosinophils and clinical outcome of acute exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis

Respiratory Medicine, Год журнала: 2023, Номер 222, С. 107501 - 107501

Опубликована: Дек. 15, 2023

Язык: Английский

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A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

International Journal of COPD, Год журнала: 2021, Номер Volume 16, С. 1093 - 1100

Опубликована: Апрель 1, 2021

Background: The exacerbation of chronic obstructive pulmonary disease (AECOPD) is a chronic, frequent, and life-threatening lung disease. In 2014, frailty index (FI) based on deficits in commonly used laboratory tests (FI-Lab) was suggested to identify older adults at increased risk death. Objective: We aim study the prognostic value FI-Lab Chinese patients who were admitted because AECOPD. Methods: screened 1932 hospitalized with AECOPD from September 2016 June 2019 Zhenjiang First People’s Hospital, China. A multivariate logistic regression analysis factors for in-hospital mortality. Results: total 77 survivors non-survivors finally included study. Both mean DECAF (including dyspnea, eosinopenia, consolidation, acidemia, atrial fibrillation) score statistically higher than those (4.45 ± 0.80 versus 3.03 0.90, P =0.000; 0.51 0.13 0.29 0.10, =0.000, respectively). Logistic that Rank strongly related death patients. areas under receiver-operating characteristic (ROC) curves 0.906 0.870 ( =0.2991). Conclusion: simple, efficient, objective tool stratify mortality Keywords: index, FI-Lab, DECAF, AECOPD, prognosis

Язык: Английский

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Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

International Journal of COPD, Год журнала: 2021, Номер Volume 16, С. 281 - 288

Опубликована: Фев. 1, 2021

Purpose: To explore the relationship between blood eosinophil concentrations in early stage and mortality critically ill patients with acute exacerbation of chronic obstructive pulmonary disease. Methods: Patient data were extracted from MIMIC-III V1.4 database. Only disease first measurement time (%) 24 hours before admission after was included. The logistic regression model used to analyze association outcomes. Results: 1019 included study. Two multivariate models built. adjusted odds ratio in-hospital mortality, in-ICU hospital length stay ICU for initial 1 (adjusted SAPS Ⅱ, cardiac arrhythmias, solid tumor, metastatic cancer, liver disease, neutrophils) 0.792 (95% CI: 0.643– 0.976, p=0.028), 0.812 0.645– 1.022, p=0.076), 0.847 0.772– 0.930, p=0.001) 0.914 0.836– 1.000, p=0.049) respectively. Meanwhile, 2 SOFA score, age, ORs 0.785 0.636– 0.968, p=0.024), 0.807 0.641– 1.016, p=0.068), 0.854 0.778– 0.939, 0.917 0.838– 1.004, p=0.060) area under ROC curve 0.608 0.559– 0.657). discriminatory thresholds 0.35% (sensitivity=0.59, specificity=0.61) mortality. Conclusion: Increased eosinophils associated decreased shorten A threshold found, but further studies needed verify it. Keywords: exacerbation, eosinophil, critical care

Язык: Английский

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Clinical features and three-year prognosis of AECOPD patients with different levels of blood eosinophils

Heart & Lung, Год журнала: 2022, Номер 56, С. 29 - 39

Опубликована: Июнь 7, 2022

Язык: Английский

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The efficacy and safety of combined traditional Chinese and western medicine in the treatment of chronic obstructive pulmonary disease complicated with respiratory failure: a systematic review and meta-analysis study

Annals of Palliative Medicine, Год журнала: 2022, Номер 11(3), С. 1102 - 1111

Опубликована: Март 1, 2022

Background: The conventional drugs to treat chronic obstructive pulmonary disease (COPD) complicated with respiratory failure (RF) (COPD + RF) in western medicine include antibiotics, etc., but the patients have serious adverse reactions and are prone drug resistance. This study aims analyze curative effect of traditional Chinese (TCM) combined Western (WM) treating COPD RF. Methods: Randomized controlled studies on treatment RF were searched PubMed, Web Science, Embase, Cochrane Library. Outcome measures efficiency, oxygen partial pressure (PO2), carbon dioxide (PCO2), function [forced expiratory volume 1 second (FEV1)%]. Reviewer's Handbook 4.2.5 was adopted for quality assessment studies, data analyzed using RevMan 5.3. Results: Seven suitable articles selected, including 490 patients. literature met requirements this article, there no obvious publication bias. effective rate TCM WM group control (WM treatment) as odds ratio (OR) [95% confidence interval (CI): 5.40 (3.14 9.29)], statistically tested Z=6.09 (P<0.00001). analysis structure PO2 after mean difference (MD) (95% CI): 5.92 (2.27 9.56), statistical suggested Z=3.18, P=0.001. PCO2 MD −4.53 (−7.14 −1.92), Z=3.40, P=0.0007. lung index 8.16 (2.57 13.75), Z=2.86 (P=0.004). Discussion: can effectively symptoms related COPD; efficiency is significantly improved compared WM; PO2, PCO2, (FEV1%) sure treatment. Data show that has a good therapeutic acute exacerbation RF, which worthy clinical application. However, included outcome indexes not sufficient, sample size should be further expanded future.

Язык: Английский

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Biomarkers as a Prognostic Factor in COPD Exacerbation: A Cohort Study

COPD Journal of Chronic Obstructive Pulmonary Disease, Год журнала: 2021, Номер 18(3), С. 325 - 332

Опубликована: Май 4, 2021

The acute exacerbations of COPD (AECOPD) are one the main causes hospitalization and morbimortality in adult population. There not many tools available to predict clinical course these patients during exacerbations. Our goal was estimate utility C Reactive Protein (CRP), Mean Platelet Volume (MPV), eosinophil count neutrophil/lymphocyte ratio (NLR) as in-hospital prognostic factors with AECOPD. A prospective cohort study conducted who consulted three reference hospitals city Medellín for AECOPD required between 2017 2020. multivariate analysis performed effect biomarkers two primary outcomes: composite outcome death and/or admission ICU hospital length-of-stay. total 610 a median age 74 years were included; 15% admitted 3.9% died hospital. In adjusted confounding variables, only marker significantly associated risk dying or being NLR > 5 (OR: 3; CI95%: 1.5; 6). Similarly, also lower probability discharged alive from institution (SHR: 0.73; 0.57; 0.94) and, therefore, longer stay. It found that greater than is strong predictor mortality admissions stay hospitalized

Язык: Английский

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High blood eosinophils predict the risk of COPD exacerbation: A systematic review and meta-analysis

PLoS ONE, Год журнала: 2024, Номер 19(10), С. e0302318 - e0302318

Опубликована: Окт. 3, 2024

Background The association between blood eosinophils and COPD exacerbation has been controversial. This study aims to investigate whether high predict the risk of across different thresholds subgroups. Methods PubMed, Embase Web science were searched for randomized controlled trial (RCT) observational studies regarding relationship exacerbation. Pooled ratio (RR) was calculated using Mantel-Haenszel method with a random-effects model. Results A total 21 (1 RCT 20 studies) 79868 participants included. Thresholds including absolute counts (200, 300 400 cell/μL) percentages (2%, 3% 4%) analyzed respectively. analyses suggested that significantly associated increased when cells/μL (RR 1.21, 95%CI 1.12–1.30, P <0.001, 16 studies), 1.79, 1.41–2.28, 3 2% 1.26, 1.02–1.55, = 0.030, 10 4% 1.44, 1.05–1.96, 0.022, 4 but not 200 ( >0.05). Moreover, contributed moderate-severe by cutoffs 1.30, 1.16–1.45, P<0.001, 11 1.33, 1.02–1.76, 0.037, 8 studies). In subgroup analyses, pooled results further showed significant (especially over cells/μL) among patients from Europe Asia, stable or phase at baseline, regardless follow-up time (≤ > 1year). Conclusions demonstrates (over 2%) could in specific However, large sample-sized, prospective, well-designed are required validate present findings.

Язык: Английский

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