Hasan Furkan AVCI, Seyma Baslilar, Bengu Saylan, Gokce Kulah*, Tayfun Caliskan, Zafer Kartaloglu, Fatih Özçelik and Oğuzhan Okutan
Objective: The eosinophil count ? 300 cells/?L is known to be related to the increased risk for exacerbations in stable COPD. But the precise 'eosinophil threshold value' that can predict the disease course during exacerbations is still unclear. We aimed to determine a cut- off value for the peripheral blood eosinophils during COPD exacerbations that will predict the outcome and recurrence. Methods: 711 patients hospitalised due to COPD exacerbation between Oct 1st, 2016 and Jan1st, 2020 were analyzed retrospectively. The cut-off values for Peripheral Blood Eosinophil Count (PBEC) and Ratio (PBER) predicting the risk for severe and recurrent exacerbations and, mortality were determined. Results: The cut-off values for PBEC and PBER were found as 170/?L and 1.15% (90.7% sensitivity, 28.3% specificity and 80.0% sensitivity, 37.3% specificity, respectively, p<0.001). The patients with low PBEC and low PBER were transferred to intensive care unit more frequently (11.3% vs. 3.2%, p<0.001 and 11.4% vs. 5.1%, p=0.008). Low PBER group had higher in hospital mortality (3.1% vs. 0.04%, p=0.036) while the long term mortality rate was higher in low PBEC group (57.7% vs. 43.9%, p<0.001). The rate of the patients with recurrent exacerbations and number of exacerbations per year were increased in both high PBEC and high PBER groups (p<0.001). Conclusions: It was determined that COPD patients hospitalized due to exacerbations with low eosinophil levels had a worse prognosis while patients with high eosinophil levels had more frequent exacerbations.
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