ระดับอีโอซิโนฟิลในเลือดสูงและระยะเวลาการนอนโรงพยาบาลในผู้ป่วยโรคปอดอุดกั้นเรื้อรัง ระยะกำเริบเฉียบพลันที่เข้ารับการรักษาในโรงพยาบาล

Nuttaya Panichdee; Pawich Paktipat

Authors

Nuttaya Panichdee Kalasin Hospital
Pawich Paktipat Maha Sarakham University

Keywords:

COPD, Blood eosinophils, Length of hospital stay

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a significant public health burden in Thailand. Acute exacerbations of COPD (AECOPD) often require hospitalization, lead to increased healthcare costs, and are associated with worse clinical outcomes. Blood eosinophil count (BEC) has emerged as a potential biomarker for predicting treatment response and disease prognosis. Objective: To evaluate the association between blood eosinophil levels and length of hospital stay in patients hospitalized with AECOPD. Methods: A retrospective cohort study was conducted on 531 patients with AECOPD admitted to Kalasin Hospital between January 2022 and July 2024. Patients were categorized into two groups based on BEC: high eosinophil group (≥ 300 cells/μL) and low eosinophil group (< 300 cells/μL). Data were analyzed using t-test and chi-square test. Results: Of the 531 patients (85.5% male, mean age 69.1±11.4 years), 172 (32.4%) had high eosinophil counts. The high eosinophil group had a significantly shorter hospital stay (3.80±0.27 days vs. 5.27±0.37 days, p = .01), received a lower total dose of dexamethasone (42.67±2.04 mg vs. 50.37±2.24 mg, p = .03) and had lower rates of endotracheal intubation (25.8% vs. 74.2%, p = .004). Conclusion: In AECOPD patients, those with blood eosinophil levels ≥300 cells/μL had shorter hospital stays than those with low eosinophil levels. Blood eosinophil level determination may aid in treatment planning and allocation of medical resources.

References

WHO. Chronic obstructive pulmonary disease (COPD) 2024. [cited 2025 May 25]. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)

Health data center. Health status of COPD: Kalasin Provincial Public Health Office [cited 2025 Jun 25]. 2025. Available from: https://hdc.moph.go.th/ksn/public/standard-subcatalog/6a1fdf282fd28180eed7d1cfe0155e11

Suissa S, Dell'Aniello S, Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax 2012;67(11):957-63.

Bafadhel M, McKenna S, Terry S, Mistry V, Reid C, Haldar P, et al. Acute exacerbations of chronic obstructive pulmonary disease: identification of biologic clusters and their biomarkers. Am J Respir Crit Care Med 2011;184(6):662-71.

Singh D, Kolsum U, Brightling CE, Locantore N, Agusti A, Tal-Singer R; ECLIPSE investigators. Eosinophilic inflammation in COPD: prevalence and clinical characteristics. Eur Respir J 2014;44(6):1697-700.

Pavord ID, Lettis S, Locantore N, Pascoe S, Jones PW, Wedzicha JA, et al. Blood eosinophils and inhaled corticosteroid/long-acting β-2 agonist efficacy in COPD. Thorax 2016;71(2):118-25.

Siddiqui SH, Guasconi A, Vestbo J, Jones P, Agusti A, Paggiaro P, et al. Blood eosinophils: a biomarker of response to extrafine beclomethasone/formoterol in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015;192(4):523-5.

Pascoe S, Locantore N, Dransfield MT, Barnes NC, Pavord ID. Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. Lancet Respir Med 2015;3(6):435-42.

Ko FWS, Chan KP, Ngai J, Ng SS, Yip WH, Ip A, et al. Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations. Respirology 2020;25(3):259-66.

Bafadhel M, McKenna S, Terry S, Mistry V, Pancholi M, Venge P, et al. Blood eosinophils to direct corticosteroid treatment of exacerbations of chronic obstructive pulmonary disease: a randomized placebo-controlled trial. Am J Respir Crit Care Med 2012;186(1):48-55.

Greulich T, Tüffers J, Mager S, Eder A, Maxheim M, Alter P, et al. High eosinophil blood counts are associated with a shorter length of hospital stay in exacerbated COPD patients - a retrospective analysis. Respir Res 2020;21(1):106.

Ko FWS, Chan KP, Ngai J, Ng S, Yip WH, Ip A, et al. Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations. Respirology 2020;25(3):259-66.

Mathioudakis AG, Bikov A, Foden P, Lahousse L, Brusselle G, Singh D, et al. Change in blood eosinophils following treatment with inhaled corticosteroids may predict long-term clinical response in COPD. Eur Respir J 2020;55(5):1902119.

Chen F, Yang M, Wang H, Liu L, Shen Y, Chen L. High blood eosinophils predict the risk of COPD exacerbation: A systematic review and meta-analysis. PLoS One 2024;19(10):e0302318.

Albuaini S, Najjar M, Tulaiba D, Al Bardan H. Impact of blood eosinophil count on clinical outcomes in hospitalized Syrian patients with COPD exacerbation. J Int Med Res 2024;52(11):3000605241299943.

Aitkazina A, Latypova N, Abishev M, Pak A, Zholshybek N, Suleimenov S, et al. Eosinophilic inflammation in COPD: mechanisms, diagnostic markers, clinical features and therapy guidance. J Clin Med Kazakhstan 2024;21(3):4–10.

Chen Y, Peng C, Zhang H, Cai Y, Yuan R, Song P, et al. Exposure to occupational risk factors is associated with the severity and progression of chronic obstructive pulmonary disease. Medicine (Baltimore) 2023;102(6):e32908.

Vila M, Sisó-Almirall A, Ocaña A, Agustí A, Faner R, Borras-Santos A, et al. Prevalence, diagnostic accuracy, and healthcare utilization patterns in patients with COPD in primary healthcare: a population-based study. npj Prim Care Respir Med 2025;35(1):17.

Fan H, Wu F, Liu J, Zeng W, Zheng S, Tian H, et al. Pulmonary tuberculosis as a risk factor for chronic obstructive pulmonary disease: a systematic review and meta-analysis. Ann Transl Med 2021;9(5):390.