Lower eosinophil count linked to mortality in patients with acute COPD exacerbation in ICU

For patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to the intensive care unit (ICU), lower eosinophil counts are associated with increased in-hospital mortality, according to a study published online Oct. 24 in BMC Pulmonary Medicine.

Rundi Gao, from The First Affiliated Hospital of Zhejiang Chinese Medical University in China, and colleagues conducted a retrospective cohort study to examine the association between blood eosinophil counts and in-hospital mortality among patients with AECOPD admitted to the ICU. The analysis included 1,855 patients with AECOPD with blood eosinophil counts measured within the first 24 hours following ICU admission. In-hospital mortality was compared for patients across eosinophil thresholds and for patients categorized into three eosinophil groups: eosinophil counts <0.1 x 10⁹/L (Group I); 0.1 x 10⁹/L ≤ eosinophil counts <0.3 x 10⁹/L (Group II); and eosinophil counts ≥0.3 x 10⁹/L (Group III), with Group I serving as the reference group.

The researchers found significant mortality differences at eosinophil thresholds of 0.10, 0.15, and 0.20 x 10⁹/L in Kaplan-Meier survival curves. Across all Cox models, Group II consistently showed a significantly lower risk for in-hospital mortality compared with Group I. Group III showed a reduction in mortality only in the unadjusted model; after adjustment, the reduction lost statistical significance. An L-shaped association was seen in a restricted cubic spline analysis, with an inflection point around 0.042 x 10⁹/L.

“Incorporating eosinophil counts into ICU triage or early management protocols may help clinicians identify high-risk patients more accurately and optimize resource allocation,” the authors write.

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