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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

PURPOSE: To explore the relationship between the blood eosinophil concentrations in the early stage and mortality in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: Patient data were extracted from the MIMIC-III V1.4 database. Only the acute exacerb...

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Autores principales: Yang, Jia, Yang, Junchao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887152/
https://www.ncbi.nlm.nih.gov/pubmed/33603354
http://dx.doi.org/10.2147/COPD.S289920
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author Yang, Jia
Yang, Junchao
author_facet Yang, Jia
Yang, Junchao
author_sort Yang, Jia
collection PubMed
description PURPOSE: To explore the relationship between the blood eosinophil concentrations in the early stage and mortality in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: Patient data were extracted from the MIMIC-III V1.4 database. Only the acute exacerbation of chronic obstructive pulmonary disease patients with the first measurement time of blood eosinophil concentrations (%) between 24 hours before admission and 24 hours after admission was included. The logistic regression model was used to analyze the association between eosinophil and outcomes. RESULTS: 1019 patients were included in the study. Two multivariate regression models were built. The adjusted odds ratio of in-hospital mortality, in-ICU mortality, hospital length of stay and ICU length of stay for initial blood eosinophil concentrations in model 1 (adjusted for SAPS Ⅱ, cardiac arrhythmias, solid tumor, metastatic cancer, liver disease, neutrophils) were 0.792 (95% CI: 0.643–0.976, p=0.028), 0.812 (95% CI: 0.645–1.022, p=0.076), 0.847 (95% CI: 0.772–0.930, p=0.001) and 0.914 (95% CI: 0.836–1.000, p=0.049) respectively. Meanwhile, in model 2 (adjusted for SOFA score, age, cardiac arrhythmias, solid tumor, metastatic cancer, liver disease, neutrophils) ORs were 0.785 (95% CI: 0.636–0.968, p=0.024), 0.807 (95% CI: 0.641–1.016, p=0.068), 0.854 (95% CI: 0.778–0.939, p=0.001) and 0.917 (95% CI: 0.838–1.004, p=0.060) respectively. The area under the ROC curve for eosinophil initial was 0.608 (95% CI: 0.559–0.657). The discriminatory eosinophil thresholds were 0.35% (sensitivity=0.59, specificity=0.61) for in-hospital mortality. CONCLUSION: Increased blood eosinophils were associated with decreased in-hospital mortality and shorten hospital length of stay in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease. A discriminatory eosinophil threshold of 0.35% for mortality was found, but further studies were needed to verify it.
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spelling pubmed-78871522021-02-17 Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study Yang, Jia Yang, Junchao Int J Chron Obstruct Pulmon Dis Original Research PURPOSE: To explore the relationship between the blood eosinophil concentrations in the early stage and mortality in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: Patient data were extracted from the MIMIC-III V1.4 database. Only the acute exacerbation of chronic obstructive pulmonary disease patients with the first measurement time of blood eosinophil concentrations (%) between 24 hours before admission and 24 hours after admission was included. The logistic regression model was used to analyze the association between eosinophil and outcomes. RESULTS: 1019 patients were included in the study. Two multivariate regression models were built. The adjusted odds ratio of in-hospital mortality, in-ICU mortality, hospital length of stay and ICU length of stay for initial blood eosinophil concentrations in model 1 (adjusted for SAPS Ⅱ, cardiac arrhythmias, solid tumor, metastatic cancer, liver disease, neutrophils) were 0.792 (95% CI: 0.643–0.976, p=0.028), 0.812 (95% CI: 0.645–1.022, p=0.076), 0.847 (95% CI: 0.772–0.930, p=0.001) and 0.914 (95% CI: 0.836–1.000, p=0.049) respectively. Meanwhile, in model 2 (adjusted for SOFA score, age, cardiac arrhythmias, solid tumor, metastatic cancer, liver disease, neutrophils) ORs were 0.785 (95% CI: 0.636–0.968, p=0.024), 0.807 (95% CI: 0.641–1.016, p=0.068), 0.854 (95% CI: 0.778–0.939, p=0.001) and 0.917 (95% CI: 0.838–1.004, p=0.060) respectively. The area under the ROC curve for eosinophil initial was 0.608 (95% CI: 0.559–0.657). The discriminatory eosinophil thresholds were 0.35% (sensitivity=0.59, specificity=0.61) for in-hospital mortality. CONCLUSION: Increased blood eosinophils were associated with decreased in-hospital mortality and shorten hospital length of stay in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease. A discriminatory eosinophil threshold of 0.35% for mortality was found, but further studies were needed to verify it. Dove 2021-02-11 /pmc/articles/PMC7887152/ /pubmed/33603354 http://dx.doi.org/10.2147/COPD.S289920 Text en © 2021 Yang and Yang. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Yang, Jia
Yang, Junchao
Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
title Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
title_full Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
title_fullStr Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
title_full_unstemmed Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
title_short Association Between Blood Eosinophils and Mortality in Critically Ill Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study
title_sort association between blood eosinophils and mortality in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887152/
https://www.ncbi.nlm.nih.gov/pubmed/33603354
http://dx.doi.org/10.2147/COPD.S289920
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