Guan Lujia, Li Jiachen, Liang Lirong, Tong Zhaohui
Department of Respiratory and Critical Care Medicine, Beijing Research Center for Respiratory Infectious Diseases, Beijing Institute of Respiratory Medicine and Beijing Chao Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Evidence-Based Medicine Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 Aug 22;20:2913-2923. doi: 10.2147/COPD.S536911. eCollection 2025.
Blood eosinophil (EOS) levels are considered a potential biomarker for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) management, but the impact of EOS stability during hospitalization on outcomes is unclear. This study examined the relationship between EOS stability and clinical outcomes in these patients.
A retrospective analysis was conducted on 2105 AECOPD patients hospitalized at Beijing Chao-Yang Hospital from 2013 to 2022. Patients were classified into four groups according to EOS counts (2%) at admission and discharge: persistent high, decreased, increased, and persistent low. Clinical characteristics and outcomes were compared between EOS stability groups. Multivariable logistic regression was used to evaluate the association between EOS stability and adverse hospital outcomes. Cox regression analysis was performed to assess the risk of AECOPD-related readmission within three years. Receiver operating characteristic (ROC) curves and nomograms were used to evaluate the predictive performance of the models.
There were 586 (27.8%), 154 (7.3%), 593 (28.2%), and 772 (36.7%) patients in the persistent high, decreased, increased, and persistent low groups, respectively. Multivariable logistic regression analysis showed that the persistent high EOS group had a significantly lower risk of adverse hospital outcomes compared to the persistent low EOS group (aOR: 0.77, 95% CI: 0.59-0.99, = 0.040). The nomogram developed based on the multivariate model demonstrated good predictive accuracy for adverse hospital outcomes, with an AUC of 0.67, and was well-calibrated. Cox regression analysis revealed that the persistent high EOS group had a higher risk of AECOPD-related readmission within three years compared to the persistent low EOS group (aHR: 1.38, 95% CI: 1.13-1.68, = 0.001).
Blood eosinophil stability during hospitalization is associated with AECOPD prognosis and may help guide inpatient treatment and identify patients at higher risk of future readmission.
血液嗜酸性粒细胞（EOS）水平被认为是慢性阻塞性肺疾病急性加重（AECOPD）管理的潜在生物标志物，但住院期间EOS稳定性对预后的影响尚不清楚。本研究探讨了这些患者中EOS稳定性与临床结局之间的关系。
对2013年至2022年在北京朝阳医院住院的2105例AECOPD患者进行回顾性分析。根据入院和出院时的EOS计数（2%）将患者分为四组：持续高、降低、升高和持续低。比较EOS稳定性组之间的临床特征和结局。采用多变量逻辑回归评估EOS稳定性与不良住院结局之间的关联。进行Cox回归分析以评估三年内AECOPD相关再入院的风险。使用受试者工作特征（ROC）曲线和列线图评估模型的预测性能。
持续高、降低、升高和持续低组分别有586例（27.8%）、154例（7.3%）、593例（28.2%）和772例（36.7%）患者。多变量逻辑回归分析显示，与持续低EOS组相比，持续高EOS组不良住院结局的风险显著降低（调整后比值比：0.77，95%置信区间：0.59-0.99，P = 0.040）。基于多变量模型开发的列线图对不良住院结局显示出良好的预测准确性，曲线下面积为0.67，且校准良好。Cox回归分析显示，与持续低EOS组相比，持续高EOS组三年内AECOPD相关再入院的风险更高（调整后风险比：1.38，95%置信区间：1.13-1.68，P = 0.001）。
住院期间血液嗜酸性粒细胞稳定性与AECOPD预后相关，可能有助于指导住院治疗并识别未来再入院风险较高的患者。
