Chronic obstructive pulmonary disease acute exacerbation: prognostic value of eosinophilia in terms of recurrence

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Published Mar 30, 2025
https://doi.org/10.62438/tunismed.v103i4.5215
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Vol. 103 No. 4 (2025): Tunis Med Apr 2025

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Ines Chermiti
Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
Raja Fadhel
Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
Hanen Ghazali
Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
Camillia Jeddi
Emergency department, Center of Mahmoud Yaakoub of Urgent Medical Assistance ,Tunis, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
Rym Hamed
Emergency department, Charles Nicolle Hospital,Tunis. Faculty of medicine of Tunis, ,University of Tunis el Manar, Tunisia
Syrine Keskes
Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
Héla Ben Turkia
Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia
Sami Souissi
Emergency department, Regional Hospital of Ben Arous,Ben Arous, Faculty of medicine of Tunis, University of Tunis el Manar, Tunisia

Abstract

Introduction : Chronic obstructive pulmonary disease (COPD) acute exacerbation (AE) increases morbidity and has an impact on health status. Inflammation plays a key role in these events. Current evidence supports use of biomarkers to guide corticosteroid therapy, which is included in the treatments of COPD AE.


Aim : The aim of our study was to determine the prognostic value of hypereosinophilia (HEo +) in patients admitted to emergency department (ED) with COPD AE in terms of recurrence (Recurrence+).


Methods: A prospective and observational study was conducted over nine months including patients admitted to ED with COPD AE. Patient history, clinical, paraclinical and therapeutic data was collected. HEo+, was defined as blood eosinophil count (BEC)≥200 cells/mm3. One month follow-up was performed. We compared two groups: Recurrence+ vs Recurrence- patients and HEo+ vs HEo- patients. Both univariate and multivariate analysis were performed to identify factors associated with COPD AE recurrence at one month.


Results: We included 252 patients. Prevalence of HEo+ was 50%. Patients with HEo+ had less severe clinical signs on admission (p=0.03), less COPD AE recurrence (p <0.001) and required less hospitalization at one month (p=0.003). Mortality was higher in HEo- patients (p=0.05). Recurrence- patients had HEo+ more frequently (61% vs 19% ; p<0.001). In multivariate analysis, we identified two predictors of recurrence of COPD: COPD group D (adjusted OR 2,3; [95% IC 1,5-3,7]; p<0,001) and non-invasive ventilation on admission (adjusted OR 3,9; [95% IC 1,1-13]; p=0,03). HEo+ was a protective factor of COPD...(abstract truncated at 250 words).

Keywords:

chronic obstructive pulmonary disease , eosinophilia, exacerbation, prognosis

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