慢性阻塞性肺疾病急性加重患者的嗜酸性粒细胞计数与临床结局
Eosinophil count and clinical outcome in patients with acute exacerbation of Chronic obstructive pulmonary disease.
作者信息
Faraji Neda, Hussain Bhat Idraak, Akrami Majid, Hosamirudsari Hadiseh, Kazemizadeh Hossein, Naderi Aryan, Mansouri Fariba
机构信息
Department of Respiratory, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Medical school, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
J Prev Med Hyg. 2024 Oct 31;65(3):E389-E394. doi: 10.15167/2421-4248/jpmh2024.65.3.3267. eCollection 2024 Sep.
INTRODUCTION
We examined the association of blood eosinophil counts at the time of AECOPD hospitalization with the risk of ICU admission as well as the hospital lengths of stay and mortality.
METHODS
In the current retrospective study, the association between blood eosinophil counts in COPD patients at the time of AECOPD hospitalization and the risk of subsequent ICU admission as well as mortality was assessed. The chi-squared test and t-test were used to compare categorical and continuous variables. The statistical significance level was set at 0.05. Kaplan-Meier curves for mortality as well as ICU admission up to 40 days after discharge from the index hospitalization were constructed using the determined optimal eosinophil threshold derived above and for the predetermined ≥ 300 vs < 300 cells/μL threshold. All analyses were performed using SPSS version 19.
RESULTS
Antibiotic prescription was significantly associated with increased ICU admission (OR = 1.57; confidence interval [95% CI] = 1.02-2.42. Patients with higher FEV1 had decreased ICU admission (OR = 0.98, 95% CI = 0.97-1.01, p = 0.1) as well as all-cause mortality compared (OR = 0.98, 95% CI= 0.92-1.04, p = 0.58). There were significantly greater mortality rates for patients with higher ESR (OR = 1.02, CI =1.01-1.03, p = 0.01) and CRP (OR = 1.02, 95% CI = 1.01-1.03, p = 0.01). There were significantly lower ICU admission rates for patients with higher FVC (OR = 0.97, 95% CI = 0.95-0.98, p = 0.002).
CONCLUSIONS
Blood eosinophil count could help determine the risk of ICU admission as well as mortality in COPD patients at the time of hospitalization.
引言
我们研究了慢性阻塞性肺疾病急性加重期（AECOPD）住院时的血液嗜酸性粒细胞计数与入住重症监护病房（ICU）的风险、住院时间及死亡率之间的关联。
方法
在当前这项回顾性研究中，评估了COPD患者在AECOPD住院时血液嗜酸性粒细胞计数与随后入住ICU的风险及死亡率之间的关联。采用卡方检验和t检验来比较分类变量和连续变量。统计显著性水平设定为0.05。使用上述确定的最佳嗜酸性粒细胞阈值以及预定的≥300与<300个细胞/μL阈值，构建了自首次住院出院后长达40天的死亡率及入住ICU情况的Kaplan-Meier曲线。所有分析均使用SPSS 19版软件进行。
结果
抗生素处方与入住ICU几率增加显著相关（比值比[OR]=1.57；置信区间[95%CI]=1.02 - 2.42）。第1秒用力呼气容积（FEV1）较高的患者入住ICU几率降低（OR = 0.98，95%CI = 0.97 - 1.01，p = 0.1），全因死亡率也较低（OR = 0.98，95%CI = 0.92 - 1.04，p = 0.58）。红细胞沉降率（ESR）较高的患者死亡率显著更高（OR = 1.02，CI = 1.01 - 1.03，p = 0.01），C反应蛋白（CRP）较高的患者也是如此（OR = 1.02，95%CI = 1.01 - 1.03，p = 0.01）。用力肺活量（FVC）较高的患者入住ICU几率显著更低（OR = 0.97，95%CI = 0.95 - 0.98，p = 0.002）。
结论
血液嗜酸性粒细胞计数有助于确定COPD患者住院时入住ICU的风险及死亡率。
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