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. 2021 Oct 14;21(1):557.
doi: 10.1186/s12877-021-02515-0.

Persistent eosinopenia is associated with in-hospital mortality among older patients: unexpected prognostic value of a revisited biomarker

Bethsabee Partouche  1 , Marion Pepin  1   2 , Pauline Mary de Farcy  3 , Jean-Emmanuel Kahn  4 , Bruno Sawczynski  5 , Laurent Lechowski  3 , Laurent Teillet  1 , Frederic Barbot  6 , Marie Herr  7 , Benjamin Davido  8
Affiliations

Persistent eosinopenia is associated with in-hospital mortality among older patients: unexpected prognostic value of a revisited biomarker

Bethsabee Partouche et al. BMC Geriatr. .

Abstract

Introduction: Infection is one of the major causes of mortality and morbidity in older adults. Available biomarkers are not associated with prognosis in older patients. This study aimed to analyze the value of eosinopenia (eosinophil count< 100/mm3) as a prognosis marker among older patients with suspected or confirmed bacterial infection.

Methods: A retrospective study was performed from 1 January to 31 December 2018 among patients in a geriatrics ward suffering from a bacterial infection treated with antibiotics. Biomarker data including the eosinophil count, neutrophil count and C-reactive protein (CRP) were collected within 4 days after patient diagnosis. Persistent eosinopenia was defined as a consistent eosinophil count< 100/mm3 between Day 2 and Day 4. The association of biomarkers with 30-day hospital mortality in a multivariate analysis was assessed and their predictive ability using the area under the ROC curve (AUC) was compared.

Results: Our study included 197 patients with a mean age of 90 ± 6 years. A total of 36 patients (18%) died during their stay in hospital. The patients who died were more likely to have persistent eosinopenia in comparison to survivors (78% versus 34%, p < 0.001). In the multivariate analysis, persistent eosinopenia was associated with in-hospital mortality with an adjusted HR of 8.90 (95%CI 3.46-22.9). The AUC for eosinophil count, CRP and neutrophil count between Day 2 and Day 4 were 0.7650, 0.7130, and 0.698, respectively.

Conclusion: Persistent eosinopenia within 4 days of diagnosis of bacterial infection appeared to be a predictor of in-hospital mortality in older patients.

Keywords: Bacterial infection; Eosinopenia; Geriatrics; Mortality; Outcome.

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Conflict of interest statement

None to declare.

Figures

Fig. 1
Fig. 1
Eosinophil count within five days of diagnosis of a bacterial infection according to in-hospital mortality. Number of patients with eosinophil count: Discharged or alive at Day 30, Day 0: n = 161, Day 1: n = 63, Day 2: n = 97, Day 3: n = 61, Day 4: n = 70. Deceased at day 30: n = 36 on day 0, n = 12 on day 1, n = 30 on day 2, n = 8 on day 3, n = 18 on day 4
Fig. 2
Fig. 2
Survival curves according to maximum eosinophil between Day 2 and Day 4 among patients with a diagnosis of infection (N = 197)
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