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Article: Variability of Blood Eosinophil Count at Stable-State in Predicting Exacerbation Risk of Chronic Obstructive Pulmonary Disease
Title | Variability of Blood Eosinophil Count at Stable-State in Predicting Exacerbation Risk of Chronic Obstructive Pulmonary Disease |
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Authors | |
Keywords | COPD COPD exacerbation eosinophil phenotype |
Issue Date | 1-Jan-2023 |
Publisher | Taylor and Francis Group |
Citation | International Journal of Chronic Obstructive Pulmonary Disease, 2023, v. 18, p. 1145-1153 How to Cite? |
Abstract | Background: Chronic obstructive pulmonary disease (COPD) phenotyping using stable-state blood eosinophil level was shown to have prognostic implication in terms of exacerbation risk. However, using a single cut-off of blood eosinophil level to predict clinical outcome has been challenged. There have been suggestions that variability of blood eosinophil count at stable-state could provide additional information on exacerbation risk. Methods: A retrospective cohort study was conducted in a major regional hospital and a tertiary respiratory referral centre in Hong Kong, including 275 Chinese patients with COPD, to investigate the possible role of variability of blood eosinophil count at stable-state to predict COPD exacerbation risk in one year. Results: Higher variability of baseline eosinophil count, which is defined as the difference of the minimal and maximal eosinophil count at stable-state, was associated with increased risk of COPD exacerbation in the follow-up period with adjusted OR (aOR) of 1.001 (95% CI = 1.000-1.003, p-value = 0.050) for 1 unit (cells/µL) increase in variability of baseline eosinophil count, aOR of 1.72 (95% CI = 1.00-3.58, p-value = 0.050) for 1 SD increase in variability of baseline eosinophil count and aOR of 1.06 (95% CI = 1.00-1.13) for 50 cells/µL increase in variability of baseline eosinophil count. The AUC by ROC analysis was 0.862 (95% CI = 0.817-0.907, p-value < 0.001). The cut-off for variability of baseline eosinophil count identified was 50 cells/µL, with sensitivity of 82.9% and specificity of 79.3%. Similar findings were also shown in the subgroup with stable-state baseline eosinophil count below 300 cells/µL. Conclusion: Variability of baseline eosinophil count at stable-state might predict the exacerbation risk of COPD, exclusively among patients with baseline eosinophil count below 300 cells/µL. The cut-off value for variability was 50 cells/µValidation of the study findings in large scale prospective study would be meaningful. |
Persistent Identifier | http://hdl.handle.net/10722/329048 |
ISSN | 2013 Impact Factor: 2.732 2023 SCImago Journal Rankings: 0.954 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Kwok, Wang Chun | - |
dc.contributor.author | Chau, Chi Hung | - |
dc.contributor.author | Tam, Terence Chi Chun | - |
dc.contributor.author | Lam, Fai Man | - |
dc.contributor.author | Ho, James Chung Man | - |
dc.date.accessioned | 2023-08-05T07:54:53Z | - |
dc.date.available | 2023-08-05T07:54:53Z | - |
dc.date.issued | 2023-01-01 | - |
dc.identifier.citation | International Journal of Chronic Obstructive Pulmonary Disease, 2023, v. 18, p. 1145-1153 | - |
dc.identifier.issn | 1176-9106 | - |
dc.identifier.uri | http://hdl.handle.net/10722/329048 | - |
dc.description.abstract | <p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) phenotyping using stable-state blood eosinophil level was shown to have prognostic implication in terms of exacerbation risk. However, using a single cut-off of blood eosinophil level to predict clinical outcome has been challenged. There have been suggestions that variability of blood eosinophil count at stable-state could provide additional information on exacerbation risk.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in a major regional hospital and a tertiary respiratory referral centre in Hong Kong, including 275 Chinese patients with COPD, to investigate the possible role of variability of blood eosinophil count at stable-state to predict COPD exacerbation risk in one year.</p><p><strong>Results: </strong>Higher variability of baseline eosinophil count, which is defined as the difference of the minimal and maximal eosinophil count at stable-state, was associated with increased risk of COPD exacerbation in the follow-up period with adjusted OR (aOR) of 1.001 (95% CI = 1.000-1.003, p-value = 0.050) for 1 unit (cells/µL) increase in variability of baseline eosinophil count, aOR of 1.72 (95% CI = 1.00-3.58, p-value = 0.050) for 1 SD increase in variability of baseline eosinophil count and aOR of 1.06 (95% CI = 1.00-1.13) for 50 cells/µL increase in variability of baseline eosinophil count. The AUC by ROC analysis was 0.862 (95% CI = 0.817-0.907, p-value < 0.001). The cut-off for variability of baseline eosinophil count identified was 50 cells/µL, with sensitivity of 82.9% and specificity of 79.3%. Similar findings were also shown in the subgroup with stable-state baseline eosinophil count below 300 cells/µL.</p><p><strong>Conclusion: </strong>Variability of baseline eosinophil count at stable-state might predict the exacerbation risk of COPD, exclusively among patients with baseline eosinophil count below 300 cells/µL. The cut-off value for variability was 50 cells/µValidation of the study findings in large scale prospective study would be meaningful.</p> | - |
dc.language | eng | - |
dc.publisher | Taylor and Francis Group | - |
dc.relation.ispartof | International Journal of Chronic Obstructive Pulmonary Disease | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | COPD | - |
dc.subject | COPD exacerbation | - |
dc.subject | eosinophil | - |
dc.subject | phenotype | - |
dc.title | Variability of Blood Eosinophil Count at Stable-State in Predicting Exacerbation Risk of Chronic Obstructive Pulmonary Disease | - |
dc.type | Article | - |
dc.identifier.doi | 10.2147/COPD.S401357 | - |
dc.identifier.scopus | eid_2-s2.0-85162711244 | - |
dc.identifier.volume | 18 | - |
dc.identifier.spage | 1145 | - |
dc.identifier.epage | 1153 | - |
dc.identifier.eissn | 1178-2005 | - |
dc.identifier.isi | WOS:001011547100001 | - |
dc.identifier.issnl | 1176-9106 | - |