Prognostic usefulness of eosinopenia in the pediatric intensive care unit

Abstract

Eosinopenia, a biomarker for infection, has recently been shown to be a predictor of adult mortality in the intensive care unit (ICU). Our study assessed the usefulness of eosinopenia as a mortality and an infection biomarker in the pediatric ICU (PICU). We compared the PICU mortality scores, eosinophil count and percentage at ICU admission between children who survived and those who did not survive and between children with infection and those without infection. A total of 150 patients were evaluated. The initial eosinophil count and percentage were significantly lower in the group that did not survive when compared to those that did survive (P < 0.001; P < 0.001). However, there was no significant difference in the eosinophil count and percentage seen in patients with and without infection. Eosinopenia, defined as an eosinophil count < 15 cells/µL and an eosinophil percentage < 0.25%, (hazard ratio [HR]: 2.96; P = 0.008) along with a Pediatric Index of Mortality (PIM) 2 (HR: 1.03; P = 0.004) were both determined to be independent predictors of mortality in the PICU. The presence of eosinopenia at the ICU admission can be a useful biomarker for mortality in children, but is not useful as a biomarker for infection.

Keywords: Biomarkers; Child; Eosinophils; Infection; Intensive Care Units; Prognosis.

Fig. 1

Receiver operating curves (ROC) of eosinophil counts and eosinophil percentages used to distiguish survivors from non-survivors. The area under the curve is 0.705 for eosinophil count (P < 0.001) and 0.725 for eosinophil percentage (P < 0.001).

Fig. 2

Survival curves for the children with eosinopenia and without eosinopenia. The eosinopenia was defined by an eosinophil count < 15 cells/µL and an eosinophil percentage < 0.25% (P < 0.001 by log-rank test).