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Observational Study
. 2015 Nov 11:10:2469-78.
doi: 10.2147/COPD.S90330. eCollection 2015.

The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia

Dildar Duman  1 , Emine Aksoy  1 , Meltem Coban Agca  1 , Nagihan Durmus Kocak  1 , Ipek Ozmen  1 , Ulku Aka Akturk  1 , Sinem Gungor  1 , Fatma Merve Tepetam  1 , Selma Aydogan Eroglu  1 , Selahattin Oztas  1 , Zuhal Karakurt  1
Affiliations
Observational Study

The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia

Dildar Duman et al. Int J Chron Obstruct Pulmon Dis. .

Erratum in

Abstract

Background: COPD exacerbations requiring hospitalization increase morbidity and mortality. Although most COPD exacerbations are neutrophilic, approximately 10%-25% of exacerbations are eosinophilic.

Aim: We aimed to evaluate mortality and outcomes of eosinophilic and non-eosinophilic COPD exacerbations and identify new biomarkers that predict survival.

Methods: A retrospective observational cohort study was carried out in a tertiary teaching hospital from January 1, 2014 to November 1, 2014. All COPD patients hospitalized with exacerbations were enrolled in the study at their initial hospitalization and followed-up for 6 months after discharge. Electronic data were collected from the hospital database. Subjects' characteristics, hemogram parameters, CRP levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-mean platelet volume ratio on admission and discharge, length of hospital stay (days), readmissions, and mortality were recorded. Patients were grouped according to peripheral blood eosinophil (PBE) levels: Group 1, >2% PBE, eosinophilic; Group 2, non-eosinophilic ≤2%. Patient survival after hospital discharge was evaluated by Kaplan-Meier survival analysis.

Results: A total of 1,704 patients hospitalized with COPD exacerbation were included. Approximately 20% were classified as eosinophilic. Six-month mortality was similar in eosinophilic and non-eosinophilic groups (14.2% and 15.2%, respectively); however, the hospital stay length and readmission rate were longer and higher in the non-eosinophilic group (P<0.001 and P<0.01, respectively). CRP and NLR were significantly higher in the non-eosinophilic group (both P<0.01). The platelet-to-mean platelet volume ratio was not different between the two groups. Cox regression analysis showed that survival was negatively influenced by elevated CRP (P<0.035) and NLR (P<0.001) in the non-eosinophilic group.

Conclusion: Non-eosinophilic patients with COPD exacerbations with high CRP and NLR values had worse outcomes than eosinophilic patients. PBE and NLR can be helpful markers to guide treatment decisions.

Keywords: chronic obstructive pulmonary disease; exacerbation; mortality; peripheral eosinophilia.

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Figures

Figure 1
Figure 1
Flow chart of patients. Abbreviations: PBE, peripheral blood eosinophil; LTOT, long-term oxygen therapy; NLR, neutrophil-to-lymphocyte ratio; PLT/MPV, platelet-to-mean platelet volume ratio.
Figure 2
Figure 2
Eosinophilic and non-eosinophilic COPD patient survival after hospital discharge (days) as determined by Kaplan–Meier analysis.
Figure 3
Figure 3
Survival functions of COPD patients according to CRP and NLR. Notes: (A) CRP values above and below 19 mg/dL for 6-month survival after discharge. (B) CRP values >19 mg/dL and, (C) CRP ≤19 mg/dL had similar survival curves in both eosinophilic groups (eosinophils ≤2% and >2%) (P>0.36). (D) Kaplan–Meier survival curves show the neutrophil-to-lymphocyte ratio (NLR) <7 and ≥7 for all patients. (E) NLR ≥7 mg/dL and (F) NLR <7 had similar survival curves in both eosinophilic groups (eosinophils ≤2% and >2%) (P>0.98).
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References

    1. Global Initiative for Chronic Obstructive Lung Disease [homepage on the Internet] Global strategy for diagnosis, management, and prevention of COPD [updated 2012] [Accessed October 5, 2015]. Available from: http://www.goldcopd.org.
    1. Singanayam A, Schembri S, Chalmers JD. Predictors of mortality in hospitalized adults with acute exacerbation of chronic obstructive pulmonary disease. A systematic review and meta-analysis. Ann Am Thorac Soc. 2013;10(2):81–89. - PubMed
    1. Brightling CE. Biomarkers that predict and guide therapy for exacerbations of chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2013;10(Suppl):S214–S219. - PubMed
    1. Tertemiz KC, Kömüs N, Ellidokuz H, Sevinç C, Cımrın AH. Kronik obstrüktif akciğer hastalığında mortalite ve mortaliteyi etkileyen faktörler [Mortality and factors affecting mortality in chronic obstructive pulmonary disease] Tuberk Toraks. 2012;60(2):114–122. Turkish. - PubMed
    1. Gunen H, Hacievliyagil SS, Kosar F, et al. Factors affecting survival of hospitalized patients with COPD. Eur Respir J. 2005;26(2):234–241. - PubMed

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