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Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

OBJECTIVE: The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pulmonary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil–lymphocyte rati...

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Autores principales: Köse Kabil, Neslihan, Karakurt, Zuhal, Gündoğuş, Baran, Güngör, Aylin, Akyüz, Kübra, Türker, Hatice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Thoracic Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544287/
https://www.ncbi.nlm.nih.gov/pubmed/37485712
http://dx.doi.org/10.5152/ThoracResPract.2023.21281
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author Köse Kabil, Neslihan
Karakurt, Zuhal
Gündoğuş, Baran
Güngör, Aylin
Akyüz, Kübra
Türker, Hatice
author_facet Köse Kabil, Neslihan
Karakurt, Zuhal
Gündoğuş, Baran
Güngör, Aylin
Akyüz, Kübra
Türker, Hatice
author_sort Köse Kabil, Neslihan
collection PubMed
description OBJECTIVE: The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pulmonary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil–lymphocyte ratio and peripheral blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary diseases. This would reduce the rate of re-hospitalization in 28 days. MATERIAL AND METHODS: Patients were hospitalized due to acute exacerbation of chronic obstructive pulmonary diseases from February 1, 2018, to January 31, 2019. Patients were divided into 2 groups: Sureyyapasa protocol group and conventional group. In the Sureyyapasa protocol group, patients were divided into 4 subgroups according to peripheral blood eosinophilia and neutrophil–lymphocyte ratio values. Treatment success was defined as 5-7 days acute exacerbation of chronic obstructive pulmonary diseases treatment was enough to discharge and no re-hospitalization within 28 days. Treatment failure was defined that the hospital stay was longer than 7 days or transport to intensive care and death or readmission to the hospital due to acute exacerbation of chronic obstructive pulmonary diseases within 28 days after discharge. RESULTS: The Sureyyapasa protocol group (n = 96) and the conventional group (n = 95) were randomly selected. The conventional group and Sureyyapasa protocol group had similar hospital stay (P = .22), and antibiotic and steroid uses were significantly higher in the conventional group than the Sureyyapasa protocol group (antibiotic use 100% vs. 83%, P < .001 and steroid use 84% vs. 29%, P < .001, respectively). Treatment failure in the conventional Group (n = 23, 24%) is higher than the Sureyyapasa protocol group (n = 17, 18%). CONCLUSIONS: Initiating treatment by evaluating eosinophilia and neutrophil–lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary diseases in the ward reduces unnecessary antibiotic and steroid use and cost rates in hospitalizations.
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spelling pubmed-105442872023-10-03 Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease Köse Kabil, Neslihan Karakurt, Zuhal Gündoğuş, Baran Güngör, Aylin Akyüz, Kübra Türker, Hatice Thorac Res Pract Original Article OBJECTIVE: The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pulmonary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil–lymphocyte ratio and peripheral blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary diseases. This would reduce the rate of re-hospitalization in 28 days. MATERIAL AND METHODS: Patients were hospitalized due to acute exacerbation of chronic obstructive pulmonary diseases from February 1, 2018, to January 31, 2019. Patients were divided into 2 groups: Sureyyapasa protocol group and conventional group. In the Sureyyapasa protocol group, patients were divided into 4 subgroups according to peripheral blood eosinophilia and neutrophil–lymphocyte ratio values. Treatment success was defined as 5-7 days acute exacerbation of chronic obstructive pulmonary diseases treatment was enough to discharge and no re-hospitalization within 28 days. Treatment failure was defined that the hospital stay was longer than 7 days or transport to intensive care and death or readmission to the hospital due to acute exacerbation of chronic obstructive pulmonary diseases within 28 days after discharge. RESULTS: The Sureyyapasa protocol group (n = 96) and the conventional group (n = 95) were randomly selected. The conventional group and Sureyyapasa protocol group had similar hospital stay (P = .22), and antibiotic and steroid uses were significantly higher in the conventional group than the Sureyyapasa protocol group (antibiotic use 100% vs. 83%, P < .001 and steroid use 84% vs. 29%, P < .001, respectively). Treatment failure in the conventional Group (n = 23, 24%) is higher than the Sureyyapasa protocol group (n = 17, 18%). CONCLUSIONS: Initiating treatment by evaluating eosinophilia and neutrophil–lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary diseases in the ward reduces unnecessary antibiotic and steroid use and cost rates in hospitalizations. Turkish Thoracic Society 2023-07-01 /pmc/articles/PMC10544287/ /pubmed/37485712 http://dx.doi.org/10.5152/ThoracResPract.2023.21281 Text en 2023 authors https://creativecommons.org/licenses/by-nc/4.0/ Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Article
Köse Kabil, Neslihan
Karakurt, Zuhal
Gündoğuş, Baran
Güngör, Aylin
Akyüz, Kübra
Türker, Hatice
Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
title Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
title_full Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
title_fullStr Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
title_full_unstemmed Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
title_short Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease
title_sort peripheral blood eosinophilia and neutrophil lymphocyte ratio in the choice of antibiotic and/or steroid in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544287/
https://www.ncbi.nlm.nih.gov/pubmed/37485712
http://dx.doi.org/10.5152/ThoracResPract.2023.21281
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