Elevated blood eosinophils in acute COPD exacerbations: better short- and long-term prognosis

• Published in: European clinical respiratory journal 2020-01, Vol.7 (1), p.1757274-1757274
• Main Authors: Jabarkhil, Ajmal, Moberg, Mia, Janner, Julie, Petersen, Mie Nymann, Jensen, Camilla Bjørn, Henrik Ängquist, Lars, Vestbo, Jørgen, Jess, Tine, Porsbjerg, Celeste
• Format: Article
• Language: English
• Subjects: Chronic obstructive lung disease; COPD; eosinophil; exacerbation; Mortality; readmission
• ISSN: 2001-8525; 2001-8525
• DOI: 10.1080/20018525.2020.1757274

Elevated eosinophils in COPD is recognized as a potential risk factor for exacerbations, but the prognostic role of elevated eosinophils during exacerbations of COPD is unclear. We investigated short-term and long-term outcomes in patients with exacerbations of eosinophilic phenotype, compared with patients with low blood eosinophils. A single-centre retrospective study of all patients admitted for a COPD exacerbation to Bispebjerg University Hospital in 2010-2011 was established by linking inpatient data with national patient and prescription registries, with a three-year follow-up period. Elevated eosinophils were defined as a blood eosinophil level at admission of ≥0.30 × 10 9 cells/L. A total of 811 patients were included; 13.2% had an eosinophilic exacerbation. The eosinophilic group had less need for non-invasive ventilation, shorter inpatient stay, and lower in-hospital mortality, compared to the non-eosinophilic group. However, the eosinophilic and non-eosinophilic groups showed similar risks of readmission (incidence rate ratio[95], 0.99 [0.73-1.36]). Three-year mortality was high in both groups, although lower in the eosinophilic group (40% vs. 54%, p = 0.006). COPD exacerbations in patients with high blood eosinophil have a better short-term prognosis without higher risk of subsequent exacerbation. Eosinophilic exacerbations have also a lower three-year mortality.