Key result
Blood eosinophil counts ≥300 cells/µL were not significantly associated with 30-day all-cause readmission compared to counts <300 cells/µL (OR 1.05; 95% CI 0.75-1.47).
Why the study?
The association between blood eosinophil counts during hospitalization for acute exacerbation of COPD and subsequent risk of all-cause and COPD-related readmission was investigated.
Does a blood eosinophil count ≥300 cells/µL predict increased risk of 30-day all-cause readmission in patients hospitalized for acute exacerbation of COPD?
Cohort (n=2,445)
Yes
Does a blood eosinophil count ≥300 cells/µL predict increased risk of 30-day all-cause readmission in patients hospitalized for acute exacerbation of COPD?
Odds Ratio: 1.05 (95% CI 0.75–1.47)
Blood eosinophil counts ≥300 cells/µL in patients hospitalized for AECOPD do not predict 30-day all-cause readmission but are associated with higher long-term and COPD-specific readmission risks.
Should not guide 30-day readmission risk assessment after AECOPD; leaves open links to long-term and COPD-specific outcomes.
Purpose: This retrospective, observational cohort study investigated the association of blood eosinophil counts within 1 week of hospitalization for acute exacerbation of COPD (AECOPD) with subsequent risk of all-cause and COPD-related readmission from a large integrated health system. Patients and Methods: Electronic medical records were extracted for index hospitalization for AECOPD at all Intermountain Healthcare hospitals. The primary outcome was the relationship of blood eosinophil count to 30-day all-cause readmission; secondary outcomes were 60-day, 90-day, and 12-month all-cause readmission, COPD-related readmission, and empiric derivation of the eosinophil count with the highest area under the curve (AUC) for predicting 30-day all-cause readmission. Results: Of 2445 included patients, 1935 (79%) had a blood eosinophil count <300 cells/µL and 510 (21%) had a count ≥300 cells/µL. Using a 300-cells/μL threshold, there was no significant difference between high and low eosinophil groups in 30-day (odds ratio [OR]=1.05, 95% confidence interval [CI]=0.75-1.47) or 60-day (OR=1.15, 95% CI=0.88-1.51) all-cause readmissions. However, patients with greater (versus lesser) eosinophil counts had increased 90-day and 12-month all-cause readmissions (OR=1.35, 95% CI=1.06-1.72, and OR=1.32, 95% CI=1.07-1.62). COPD-related readmission rates were significantly greater for patients with greater (versus lesser) eosinophil counts at 30, 60, and 90 days and 12 months (OR range=1.52-1.97). A total of 70 cells/µL had the most discriminatory power to predict 30-day all-cause readmission (highest AUC). Conclusion: Eosinophil counts in patients with COPD were not associated with a difference in 30-day all-cause readmissions. However, greater eosinophil counts were associated with increased risk of all-cause readmission at 90 days and 12 months and COPD-related readmission at 30, 60, and 90 days and 12 months. Patients with eosinophils <70 cells/μL had the lowest risk for 30-day all-cause readmission. Blood eosinophils in patients hospitalized with AECOPD may be a useful biomarker for the risk of hospital readmission.
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Hegewald et al. (2020) conducted a cohort in Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (n=2,445). Blood eosinophil count ≥300 cells/µL vs. Blood eosinophil count <300 cells/µL was evaluated on 30-day all-cause readmission (OR 1.05, 95% CI 0.75-1.47). Blood eosinophil counts ≥300 cells/µL were not significantly associated with 30-day all-cause readmission compared to counts <300 cells/µL (OR 1.05; 95% CI 0.75-1.47).
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