Blood eosinophil count correlates with severity of respiratory failure in life‐threatening asthma and predicts risk of subsequent exacerbations
| العنوان: | Blood eosinophil count correlates with severity of respiratory failure in life‐threatening asthma and predicts risk of subsequent exacerbations |
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| المؤلفون: | Lay-Ping Neo, Kian Fan Chung, Anthony Yii, Andrew Li, Ser Hon Puah, Tunn-Ren Tay, Rae-Ann Tan, Mariko Siyue Koh, Hui-Fang Lim, Priscilla Lau |
| المصدر: | Clinical & Experimental Allergy. 49:1578-1586 |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, medicine.medical_specialty, Exacerbation, Immunology, Respiratory arrest, Severity of Illness Index, pCO2, Leukocyte Count, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, medicine, Humans, Immunology and Allergy, Aged, Retrospective Studies, Asthma, business.industry, Hazard ratio, Middle Aged, Eosinophil, medicine.disease, Eosinophils, 030104 developmental biology, medicine.anatomical_structure, 030228 respiratory system, Respiratory failure, Arterial blood, Female, medicine.symptom, Respiratory Insufficiency, business, Follow-Up Studies |
| الوصف: | Background An elevated blood eosinophil count when asthma is stable predicts exacerbations and therapeutic response to corticosteroids or biologics targeting eosinophils. Few studies have examined the prognostic value of blood eosinophils measured at exacerbation. Aim To elucidate the relationship between a spot blood eosinophil count-measured at the onset of a life-threatening asthma exacerbation-with indices of exacerbation severity and risk of subsequent exacerbations. Methods Real-world, retrospective review of all life-threatening asthma cases admitted at 4 public hospitals in Singapore between 2011-2015. We assessed the trends and correlations between blood eosinophil count on admission with arterial blood gas values, duration of mechanical ventilation, and risk of death, hypoxic ischemic encephalopathy or respiratory arrest. Risk of future exacerbations among survivors was modelled using Cox regression and survival curves. Results There were 376 index life-threatening exacerbations with median blood eosinophil count (5-95th percentiles) of 0.270 × 109 /L (0-1.410 × 109 /L). Arterial pH decreased and PCO2 increased with increasing eosinophil count. Duration of mechanical ventilation and risk of death, hypoxic ischaemic encephalopathy or respiratory arrest did not vary with eosinophils. Among 329 survivors who were followed-up over a median of 52 months, blood eosinophils ≥1.200 × 109 /L was associated with an increased hazard of emergency visits and/or admissions for asthma (hazard ratio 1.8, 95% confidence interval 1.1-2.9, P = .02). Conclusion In this study of life-threatening asthma, we found that a spot blood eosinophil count correlates with severity of respiratory failure and predicts risk of subsequent exacerbations. |
| تدمد: | 1365-2222 0954-7894 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b748424c6852983153b8ccce1c6d22c6Test https://doi.org/10.1111/cea.13465Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....b748424c6852983153b8ccce1c6d22c6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13652222 09547894 |
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