Ercan GÜRLEVİK, Basar CANDER, Bora ÇEKMEN, Serdar ÖZDEMİR

Kronik Obstrüktif Akciğer Hastalığı Alevlenmesinde Eozinofil Sayısı ve Yüzdesinin Rolü: Bir Gözlemsel Retrospektif Çalışma

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH) alevlenmesi ile hastaneye yatırılan hastalarda başvuru anında değerlendirilen eozinofil sayısı ve yüzdesinin rolünü ortaya çıkarmak. Gereç ve Yöntemler: Bu çalışmada, acil servise başvuran ve genel dahiliye servisine yatırılan KOAH alevlenmesi olan 156 hastanın verileri geriye dönük olarak incelendi. Eozinofil sayısı ve oranlarının hastanede kalış süresi ve yoğun bakım gereksinimi ile ilişkisi araştırıldı. Spearman korelasyon testi ile sonlanım ile parametreler arası korelasyon araştırıldı. Bulgular: Çalışma popülasyonunun, %39,7’si kadın ve %60,3’ü erkek idi. Olguların yaşları 25 ile 94 arasında değişmekte olup, medyan değeri 76 idi. Serviste kalış süresi ile eozinofil sayısı ve yüzdesi arasında anlamlı bir ilişki yoktu (sırasıyla rho=-0,148, p=0,066 ve p=0,074, rho=-0,143) (Spearman korelasyon testi). Yoğun bakım ünitesine kabul edilen grup, yoğun bakım gerektirmeyen gruba göre önemli ölçüde daha yüksek eozinofil sayısına ve eozinofil yüzdesine sahipti (0,81(Çeyrekler arası aralık (ÇAA):0,41-1,31)’ e karşı 1,32 (ÇAA:0,83-1,43) p=0,042 ve 1,0 (ÇAA:0,81-1,21)’e karşı 1,42 (ÇAA:1,02-1,64), p=0,018, sırasıyla). Sonuç: Yüksek eozinofil sayısı ve yüzdesi ile hastanede kalış süresi arasında ilişki yoktu. Ancak yoğun bakıma ihtiyacı olan hastalarda eozinofil sayısı ve yüzdesi anlamlı olarak daha yüksekti.

Anahtar Kelimeler:

kronik obstrüktif akciğer hastalığı, hastanede kalış süresi, eozinofil, yoğun bakım ünitesi, hastaneye yatış

Role of Eosinophil Count and Percentage in Chronic Obstructive Pulmonary Disease Exacerbation: A Retrospective Observational Study

Aim: To reveal the role of eosinophil count and percentage evaluated at the time of presentation in patients hospitalized with the exacerbation of chronic obstructive pulmonary disease (COPD). Material and Methods: In this study, the data of patients with a diagnosis of the exacerbation of COPD, who presented to the emergency department, and admitted to the general internal medicine ward, were retrospectively analyzed. The relationship of eosinophil count and ratios with the length of hospital stay and intensive care requirement was investigated.The Spearman correlation analysis was used for investigating correlation between parameters and outcome. Results: Of the study population, 39.7% were female and 60.3% were male. The ages of the participants ranged from 25 to 94 years, with a median value of 76 years. There was no significant correlation between the length of stay in ward and eosinophil count and percentage (rho=-0.148, p=0.066 and p=0.074, rho=-0.143, respectively) (Spearman correlation test). The group admitted to the intensive care unit had a significantly higher eosinophil count and percentage of eosinophils than the group that did not require intensive care (0.81(Inter Quarter Range (IQR):0.41-1.31) versus 1.32 (IQR:0.83-1.43) p=0.042 and 1.0 (IQR:0.81-1.21) versus 1.42 (IQR:1.02-1.64), p=0.018, respectively) (Mann Whitney U test). Conclusion: There was no correlation between a high eosinophil count and percentage and the length of hospital stay. However, the number and percentage of eosinophils were significantly higher among the patients requiring intensive care.

Keywords:

chronic obstructive pulmonary disease, length of hospital stay, eosinophil, hospitalization, intensive care unit,

PDF

___

Yurtseven M. Kronik Obstrüktif Akciğer Hastalığında Üst Ekstremite Fonksiyonel Değerlendirmesi: Bir Derleme Makalesi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2022; (16): 302-312.
World health organization (2018) the 10 leading causes of death in the world, 2006 and 2018 (updated2020) the web site: http://www.who.int/mediacentre/factsheets/fs310/en/#
Agusti AGN, Noguera A, Sauleda J, Pons J, Busquets. Systemic effects of chronic obstructive pulmonary disease. Eur respire J 2003 21: 347-360.
Murray CJL, Lopez AD. Global mortality, disability and the contribution of risk factors: Global burden of diseae study. Lancet 1997; 1436-42.
Van Rossem I, Hanon S, Verbanck S, Vanderhelst E. Blood Eosinophil Counts in Chronic Obstructive Pulmonary Disease: Adding Within-Day Variability to the Equation. Am J Respir Crit Care Med. 2022 Mar 15;205(6):727-729. doi: 10.1164/rccm.202105-1162LE.
Annangi S, Nutalapati S, Sturgill J, Flenaugh E, Foreman M. Eosinophilia and fractional exhaled nitric oxide levels in chronic obstructive lung disease. Thorax. 2022 Apr;77(4):351-356. doi: 10.1136/thoraxjnl-2020-214644.
Du X, Li F, Zhang C, Li N, Huang H, Shao Z, Zhang M, Zhan X, He Y, Ju Z, Li W, Chen Z, Ying S, Shen H. Eosinophil-derived chemokine (hCCL15/23, mCCL6) interacts with CCR1 to promote eosinophilic airway inflammation. Signal Transduct Target Ther. 2021 Feb 28;6(1):91. doi: 10.1038/s41392-021-00482-x.
Liu T, Xiang ZJ, Hou XM, Chai JJ, Yang YL, Zhang XT. Blood eosinophil count-guided corticosteroid therapy and as a prognostic biomarker of exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ther Adv Chronic Dis. 2021 Jul 7;12:20406223211028768. doi: 10.1177/20406223211028768.
Csoma B, Bikov A, Tóth F, Losonczy G, Müller V, Lázár Z. Blood eosinophils on hospital admission for COPD exacerbation do not predict the recurrence of moderate and severe relapses. ERJ Open Res. 2021 Feb 8;7(1):00543-2020. doi: 10.1183/23120541.00543-2020.
Helala LA, AbdelFattah EB, Elsalam HMA. Blood and sputum eosinophilia in COPD exacerbation. Egypt J Bronchol 2022;16: 49. Doi:10.1186/s43168-022-00151-9.
Duman D, Aksoy E, Coban Agca M, Durmus Kocak N, Ozmen İ, Aka Akturk U, Gungor S, Tepetam FM, Aydogan Eroglu S, Oztas S, Karakurt Z. The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia. International Journal of COPD. 2015:10 2469–2478.
Couillard S, Larivée P, Courteau J, Vanasse A. Eosinophils in COPD Exacerbations Are Associated With Increased Readmissions. Chest. 2017 Feb;151(2):366-373. doi: 10.1016/j.chest.2016.10.003.
Saltürk C, Karakurt Z, Adiguzel N, Kargin F, Sari R, Celik ME, Takir HB, Tuncay E, Sogukpinar O, Ciftaslan N, Mocin O, Gungor G, Oztas S. Does eosinophilic COPD exacerbation have a better patient outcome than non-eosinophilic in the intensive care unit?. Int J Chron Obstruct Pulmon Dis. 2015;10:1837-1846. doi:10.2147/COPD.S88058
Singh D, Kolsum U, Brightling CE, Locantore N, Agusti A, Tal-Singer R; ECLIPSE investigators. Eosinophilic inflammation in COPD: prevalence and clinical characteristics. Eur Respir J. 2014;44(6): 1697–1700.
Hospers JJ, Schouten JP, Weiss ST, Rijcken B, Postma DS. Asthma attacks with eosinophilia predict mortality from chronic obstructive pulmonary disease in a general population sample. Am J Respir Crit Care Med. 1999;160:1869–1874.
Steer J, Gibson J, Bourke SC. The DECAF score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax 2012;67:970-6.
Vogelmeier CF, Kostikas K, Fang J, Tian H, Jones B, Morgan CL, Fogel R, Gutzwiller FS, Cao H. Evaluation of exacerbations and blood eosinophils in UK and US COPD populations. Respir Res. 2019 Aug 7;20(1):178. doi: 10.1186/s12931-019-1130-y.
Mycroft K, Krenke R, Górska K. Eosinophils in COPD-Current Concepts and Clinical Implications. J Allergy Clin Immunol Pract. 2020 Sep;8(8):2565-2574. doi: 10.1016/j.jaip.2020.03.017.
David B, Bafadhel M, Koenderman L, De Soyza A. Eosinophilic inflammation in COPD: from an inflammatory marker to a treatable trait. Thorax. 2021 Feb;76(2):188-195. doi: 10.1136/thoraxjnl-2020-215167.