Department of Internal Diseases, University of Health Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Department of Rheumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Medicine (Baltimore). 2024 May 31;103(22):e38359. doi: 10.1097/MD.0000000000038359.
The aim of this study was to investigate all-cause mortality rates and related factors in patients with different levels of eosinophilia. This retrospective cohort study was conducted between January 2020 and December 2022 in the Internal Medicine Department of Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkiye. A total of 161 patients with eosinophilia (at least 3 times) were included and divided into groups with absolute eosinophil counts of 500-999/µL (mild), 1000-1500/µL (moderate), and >1500/µL (severe). The mean age of patients was 65.67 ± 16.64 years at the time of admission, and 45 patients (57.8%) were male. The rates of mortality, oncological disease, and organ involvement were significantly higher in the severe group (P < .05). Increased serum total immunoglobulin E and vitamin B12, hematocrit value, eosinophil-to-lymphocyte ratio, and leukocyte were observed in eosinophilic patients. Decreased lymphocyte count, hemoglobin and hematocrit values were higher in deceased patients than in survivors (P < .05). Increased eosinophil-to-lymphocyte ratio, C-reactive protein, vitamin B12, and lactate dehydrogenase (LDH) activity were observed in participants who died compared to those who survived (P < .05). Multivariable logistic regression revealed that advanced age and higher LDH activity were independently associated with greater mortality risk while receiving non-steroid anti-inflammatory drugs or proton-pump inhibitors were associated with reduced mortality risk (P < .05). Advanced age and increased LDH activity were independently associated with greater risk for mortality, whereas absolute eosinophil counts was not. Considering the literature on this topic, our results show the need for further clinical and fundamental research to understand the role of eosinophils in human disease.
本研究旨在探讨不同嗜酸性粒细胞水平患者的全因死亡率及其相关因素。这是一项回顾性队列研究,于 2020 年 1 月至 2022 年 12 月在土耳其伊斯坦布尔 Sadi Konuk 培训和研究医院内科进行。共纳入 161 例嗜酸性粒细胞增多症(至少 3 倍)患者,根据绝对嗜酸性粒细胞计数分为 500-999/μL(轻度)、1000-1500/μL(中度)和 >1500/μL(重度)组。患者入院时的平均年龄为 65.67±16.64 岁,其中 45 例(57.8%)为男性。重度组的死亡率、肿瘤性疾病和器官受累发生率显著高于轻度组(P<.05)。嗜酸性粒细胞增多症患者的血清总免疫球蛋白 E 和维生素 B12、红细胞压积值、嗜酸性粒细胞与淋巴细胞比值和白细胞升高。与存活者相比,死亡者的淋巴细胞计数、血红蛋白和红细胞压积值降低(P<.05)。与存活者相比,死亡者的嗜酸性粒细胞与淋巴细胞比值、C 反应蛋白、维生素 B12 和乳酸脱氢酶(LDH)活性更高(P<.05)。多变量逻辑回归显示,高龄和更高的 LDH 活性与更高的死亡率风险独立相关,而使用非甾体抗炎药或质子泵抑制剂与降低的死亡率风险相关(P<.05)。高龄和 LDH 活性升高与死亡率风险增加独立相关,而绝对嗜酸性粒细胞计数与死亡率风险无关。考虑到该主题的文献,我们的结果表明需要进一步的临床和基础研究来了解嗜酸性粒细胞在人类疾病中的作用。