Source: International Congress 2014 – Different interesting issues in respiratory infections: 1
Disease area: Respiratory infections

Abstract

IntroductionBlood eosinophil count is an independent predictor of mortality in patients: with bacteraemia; requiring intensive care; and with acute exacerbations of COPD (AECOPD). In AECOPD eosinopenia may be related to steroid use prior to admission. We describe eosinopenia and mortality in patients with pneumonia and no chronic lung disease or maintenance steroid use.Methods198 patients, mean (SD) age 74 (16) years, were identified and data for mortality, eosinopenia (<0.05x10^9/l) and CURB-65 score (Confusion, Urea >7 mmol/l, Respiratory rate >30/min, low systolic (<90 mm Hg) or diastolic (<60 mm Hg) Blood pressure), age >65 years) were collected. Odds ratios (OR) for death at 30 days were calculated.Results

	30 day mortality
	Dead	Total	% dead	OR (95% CI)
Confusion score 1	38	87	43.7	4.3 (2.2-8.4)
Confusion score 0	17	111	15.3
Urea score 1	47	125	37.6	4.9 (2.2-11.1)
Urea score 0	8	73	11.0
Resp. Rate score 1	15	38	39.5	2.0 (0.9-4.1)
Resp. Rate score 0	40	160	25.0
BP score 1	17	48	35.4	1.6 (0.8-3.3)
BP score 0	38	151	25.2
Age score 1	53	150	35.3	12.6 (2.9-53.9)
Age score 0	2	48	4.2
Eosinopenia	41	123	33.3	2.2 (1.1-4.3)
No eosinopenia	14	75	18.7

A higher proportion of patients with eosinopenia had a raised CRP (>50mg/l) compared with those without eosinopenia (81.3% vs. 62.7% p<0.05).DiscussionBlood eosinopenia <0.05x10^9/l was a strong predictor of 30 day mortality in this cohort with pneumonia, and no chronic respiratory disease. This association cannot be ascribed to steroid use. Eosinopenia may be a marker of severe sepsis and consequent mortality risk (Shaaban et al 2010; Abidi et al 2008), however the association between eosinopenia and CRP >50mg/l was weak.

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C. Echevarria, T. Hartley, T. Nagarajan, H. Tedd, J. Steer, G. J. Gibson, S. C. Bourke (North Shields, Newcastle, United Kingdom). 30 day mortality and eosinopenia in patients with pneumonia. Eur Respir J 2014; 44: Suppl. 58, 2550

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