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. 2020 Apr 30;7(1):1757274.
doi: 10.1080/20018525.2020.1757274. eCollection 2020.

Elevated blood eosinophils in acute COPD exacerbations: better short- and long-term prognosis

Ajmal Jabarkhil  1 , Mia Moberg  1 , Julie Janner  1 , Mie Nymann Petersen  1 , Camilla Bjørn Jensen  2 , Lars Henrik Äangquist  3 , Jørgen Vestbo  4 , Tine Jess  2 , Celeste Porsbjerg  1
Affiliations

Elevated blood eosinophils in acute COPD exacerbations: better short- and long-term prognosis

Ajmal Jabarkhil et al. Eur Clin Respir J. .

Abstract

Background: Elevated eosinophils in COPD is recognized as a potential risk factor for exacerbations, but the prognostic role of elevated eosinophils during exacerbations of COPD is unclear. We investigated short-term and long-term outcomes in patients with exacerbations of eosinophilic phenotype, compared with patients with low blood eosinophils. Methods: A single-centre retrospective study of all patients admitted for a COPD exacerbation to Bispebjerg University Hospital in 2010-2011 was established by linking inpatient data with national patient and prescription registries, with a three-year follow-up period. Elevated eosinophils were defined as a blood eosinophil level at admission of ≥0.30 × 109 cells/L. Results: A total of 811 patients were included; 13.2% had an eosinophilic exacerbation. The eosinophilic group had less need for non-invasive ventilation, shorter inpatient stay, and lower in-hospital mortality, compared to the non-eosinophilic group. However, the eosinophilic and non-eosinophilic groups showed similar risks of readmission (incidence rate ratio[95], 0.99 [0.73-1.36]). Three-year mortality was high in both groups, although lower in the eosinophilic group (40% vs. 54%, p = 0.006). Conclusions: COPD exacerbations in patients with high blood eosinophil have a better short-term prognosis without higher risk of subsequent exacerbation. Eosinophilic exacerbations have also a lower three-year mortality.

Keywords: COPD; Chronic obstructive lung disease; eosinophil; exacerbation; mortality; readmission.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Flowchart of the cohort selection.
Figure 2.
Figure 2.
Risk of exacerbations and mortality in eosinophilic compared to non-eosinophilic COPD.
Figure 3.
Figure 3.
All-cause mortality in follow-up period.
See this image and copyright information in PMC

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