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Multicenter Study
. 2023 Mar;49(3):291-301.
doi: 10.1007/s00134-022-06967-9. Epub 2023 Feb 1.

Epidemiology, clinical presentation, and outcomes of 620 patients with eosinophilia in the intensive care unit

Antoine Gaillet  1   2   3 , Pierre Bay  4   5 , Edwige Péju  6 , Hafid Ait-Oufella  7 , Elie Azoulay  8 , Nacime Benchabane  9 , Charles Cerf  10 , Yves Cohen  11 , Nicolas de Prost  4 , Stanislas Faguer  12 , Guillaume Geri  13 , Steven Grangé  14 , Jean-Emmanuel Kahn  15   16 , Louis Kreitmann  17 , Romaric Larcher  9 , Guillaume Lefèvre  15   18 , Asma Mabrouki  8 , Armand Mekonsto-Dessap  4 , Kewin Panel  19   15 , Frédéric Pène  6 , Marc Pineton de Chambrun  5 , Jean-Pierre Quenot  20 , Yacine Tandjaoui-Lambiotte  11   21 , Jean-Francois Timsit  22 , Antoine Vieillard-Baron  13 , Auguste Dargent  17 , Antoine Herault  14 , Matthieu Groh  19   15   23
Affiliations
Multicenter Study

Epidemiology, clinical presentation, and outcomes of 620 patients with eosinophilia in the intensive care unit

Antoine Gaillet et al. Intensive Care Med. 2023 Mar.

Erratum in

Abstract

Purpose: Although eosinophil-induced manifestations can be life-threatening, studies focusing on the epidemiology and clinical manifestations of eosinophilia in the intensive care unit (ICU) are lacking.

Methods: A retrospective, national, multicenter (14 centers) cohort study over 6 years of adult patients who presented with eosinophilia ≥ 1 × 109/L on two blood samples performed from the day before admission to the last day of an ICU stay.

Results: 620 patients (0.9% of all ICU hospitalizations) were included: 40% with early eosinophilia (within the first 24 h of ICU admission, ICU-Eo1 group) and 56% with delayed (> 24 h after ICU admission, ICU-Eo2 group) eosinophilia. In ICU-Eo1, eosinophilia was mostly due to respiratory (14.9%) and hematological (25.8%) conditions, frequently symptomatic (58.1%, mainly respiratory and cardiovascular manifestations) requiring systemic corticosteroids in 32.2% of cases. In ICU-Eo2, eosinophil-related organ involvement was rare (25%), and eosinophilia was mostly drug-induced (46.8%). Survival rates at day 60 (D60) after ICU admission were 21.4% and 17.2% (p = 0.219) in ICU-Eo1 and ICU-Eo2 patients, respectively. For ICU-Eo1 patients, in multivariate analysis, risk factors for death at D60 were current immunosuppressant therapy at ICU admission, eosinophilia of onco-hematological origin and the use of vasopressors at ICU admission, whereas older age and the use of vasopressors or mechanical ventilation at the onset of eosinophilia were associated with a poorer prognosis for ICU-Eo2 patients.

Conclusion: Eosinophilia ≥ 1 × 109/L is not uncommon in the ICU. According to the timing of eosinophilia, two subsets of patients requiring different etiological workups and management can be distinguished.

Keywords: Diagnosis differential; Eosinophilia; Hypereosinophilic syndrome; Intensive care unit (ICU); Outcome assessment.

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