Chronic obstructive pulmonary disease acute exacerbation: prognostic value of eosinophilia in terms of recurrence

Authors

  • Ines Chermiti Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
  • Raja Fadhel Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
  • Hanen Ghazali Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
  • Camillia Jeddi Emergency department, Center of Mahmoud Yaakoub of Urgent Medical Assistance ,Tunis, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
  • Rym Hamed Emergency department, Charles Nicolle Hospital,Tunis. Faculty of medicine of Tunis, ,University of Tunis el Manar, Tunisia
  • Syrine Keskes Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
  • Héla Ben Turkia Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
  • Sami Souissi Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia

DOI:

https://doi.org/10.62438/tunismed.v103i4.5215

Keywords:

chronic obstructive pulmonary disease , eosinophilia, exacerbation, prognosis

Abstract

Introduction : Chronic obstructive pulmonary disease (COPD) acute exacerbation (AE) increases morbidity and has an impact on health status. Inflammation plays a key role in these events. Current evidence supports use of biomarkers to guide corticosteroid therapy, which is included in the treatments of COPD AE.

Aim : The aim of our study was to determine the prognostic value of hypereosinophilia (HEo +) in patients admitted to emergency department (ED) with COPD AE in terms of recurrence (Recurrence+).

Methods: A prospective and observational study was conducted over nine months including patients admitted to ED with COPD AE. Patient history, clinical, paraclinical and therapeutic data was collected. HEo+, was defined as blood eosinophil count (BEC)≥200 cells/mm3. One month follow-up was performed. We compared two groups: Recurrence+ vs Recurrence- patients and HEo+ vs HEo- patients. Both univariate and multivariate analysis were performed to identify factors associated with COPD AE recurrence at one month.

Results: We included 252 patients. Prevalence of HEo+ was 50%. Patients with HEo+ had less severe clinical signs on admission (p=0.03), less COPD AE recurrence (p <0.001) and required less hospitalization at one month (p=0.003). Mortality was higher in HEo- patients (p=0.05). Recurrence- patients had HEo+ more frequently (61% vs 19% ; p<0.001). In multivariate analysis, we identified two predictors of recurrence of COPD: COPD group D (adjusted OR 2,3; [95% IC 1,5-3,7]; p<0,001) and non-invasive ventilation on admission (adjusted OR 3,9; [95% IC 1,1-13]; p=0,03). HEo+ was a protective factor of COPD...(abstract truncated at 250 words).

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2025-03-30

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Vol. 103 No. 4 (2025): Tunis Med Apr 2025

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