A revised treatment approach for hospitalized patients with eosinophilic and neutrophilicexacerbations of chronic obstructive pulmonary disease
Yükleniyor...
Dosyalar
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bılımsel tıp publıshıng house, bukres sokak no 3-20 kavaklıdere, ankara, 00000, turkey
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
OBJECTIVES: The choice of treatment according to the inflammation type in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been of recent interest. This study investigated the role of novel biomarkers, hospital outcomes, and readmission rates in the first month in patients with eosinophilic or neutrophilic AECOPD.
MATERIALS AND METHODS: We conducted a retrospective observational cohort study in a Chest Teaching Hospital with hospitalized AECOPD patients. Subjects' characteristics, hemogram results, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR), platelet/mean platelet volume (PLT/MPV), length of hospital stay, mortality, and steroid use were recorded. Eosinophilic AECOPD defined as peripheral blood eosinophilia (PBE) was >2% and neutrophilic AECOPD as PBE Q%. Readmission within 28 days of discharge was recorded.
RESULTS: Of 2727(31.5% females) patients, eosinophilic AECOPD was found in 510 (18.7%) patients. Leucocytes, CRF,' NLR, and PLR were significantly higher in neutrophilic AECOPD than in eosinophilic AECOPD (p<0.001). Steroid use and mortality rate were 45% and 0.6% in eosinophilic AECOPD and 71%, and 1.4% in neutrophilic AECOPD, respectively (p=0.001, p=0.19). Age >75 years, albumin <2.5 g/dL, CRP >50 mg/dL, and PLT/MPV <20x103 were found to be risks factors for hospital mortality (p<0.05 each). Readmission rates within 28 days of discharge were 5% (n=136), and this rate was higher in eosinophilic AECOPD patients not taking steroids (p<0.001).
CONCLUSION: NLR, PLR, and CRP levels were higher in neutrophilic AECOPD compared with eosinophilic AECOPD. These markers decreased with treatment in neutrophilic AECOPD. A PLT/MPV ratio of <20x103 resulted in an increased mortality rate. Thus, appropriate steroid therapy may reduce readmission rates in the first 28 days after discharge in eosinophilic AECOPD.
Açıklama
Anahtar Kelimeler
Platelet-lymphocyte ratıo, cortıcosteroıd treatment, aırway ınflammatıon, sputum-eosınophılıa, blood eosınophıls, controlled-trıal, copd, bıomarkers, mortalıty, volume
Kaynak
Turkısh thoracıc journal
WoS Q Değeri
Scopus Q Değeri
Cilt
19
Sayı
4
Künye
Aksoy, E. Gungor, S . Agca, MC. Ozmen, I. Duman, D. Kocak, ND. Akturk, UA . Tuncay, E. Salturk, C. Yalcinsoy, M. (2018). A revised treatment approach for hospitalized patients with eosinophilic and neutrophilicexacerbations of chronic obstructive pulmonary disease. Cilt:19.Sayı:4. 193-200 ss.
