Independent factors associate with hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease requiring intensive care unit admission: Focusing on the eosinophil-to-neutrophil ratio

• Published in: PloS one 2019-07, Vol.14 (7), p.e0218932-e0218932
• Main Authors: Chen, Pei-Ku, Hsiao, Yi-Han, Pan, Sheng-Wei, Su, Kang-Cheng, Perng, Diahn-Warng, Ko, Hsin-Kuo
• Format: Article
• Language: English
• Subjects: Acute Disease; Age Factors; Aged; Aged, 80 and over; Antibiotics; Bioindicators; Biological markers; Biology and Life Sciences; Biomarkers; Biomarkers - blood; C-reactive protein; C-Reactive Protein - metabolism; Care and treatment; Case-Control Studies; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Complications; Demographic aspects; Disease Progression; Electronic health records; Emergency medical care; Emergency medical services; Eosinophils - pathology; Female; Hospital Mortality - trends; Hospitalization; Hospitals; Humans; Identification methods; Infections; Intensive care; Intensive Care Units; Leukocytes (eosinophilic); Logistic Models; Lung diseases; Male; Medical records; Medicine; Medicine and Health Sciences; Mortality; Neutrophils; Neutrophils - pathology; Obstructive lung disease; Odds Ratio; Patient outcomes; Patients; Physical Sciences; Physiology; Prevention; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - physiopathology; Rank tests; Regression analysis; Respiratory tract diseases; Retrospective Studies; ROC Curve; Statistical analysis; Synergistic effect; Taiwan; Ventilators
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0218932

Factors associated with hospital mortality are unclear in patients with acute exacerbation of COPD (AECOPD) requiring intensive care unit (ICU) admission. We aimed to characterize these patients and identify factors associated with hospital mortality. We used a retrospective observational case-control design and recruited patients between January 2015 and March 2017. Of 146 patients enrolled, 24 (16.4%) died during their hospital stay, while 122 survived. Multivariate logistic regression analyses revealed factors associated with hospital mortality: age (adjusted odds ratio [AOR] 1.12, 95% CI: 1.03-1.23), C-reactive protein (CRP) level >7.5 mg/dL at the emergency room (AOR 4.52, 95% CI: 1.27-16.04), peak eosinophil-to-neutrophil ratio (ENR)×102 on days 8-14 of treatment (AOR 0.22, 95% CI: 0.08-0.63), and in-hospital complications (AOR 4.23, 95% CI: 1.12-15.98) (all P0.224 on days 8-14 and initial CRP 0.224 on days 8-14 and initial CRP >7.5 mg/dL; (G2) Peak ENR×102