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Eosinopenia, an early marker of increased mortality in critically ill medical patients

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Abstract

Purpose

Inflammatory markers may have a role in predicting severity of illness of intensive care unit (ICU) patients. The aim of this study is to determine whether low eosinophil count can predict 28-day mortality in medical ICU.

Methods

A prospective study over a 4-month period. To evaluate the prognosis information provided by eosinophil count, we compared the variations in eosinophil count from ICU admission to seventh day between patients who survived and those who died. The best cutoff value was chosen using Younden’s index for identification of patients with high risk of mortality. The patient outcome was 28-day mortality.

Results

A total of 200 patients were eligible. Overall 28-day ICU mortality was 28% (n = 56). At ICU admission, the median eosinophil count was significantly different in survivors [30 cells/mm³; interquartile range (IQR), 0–100 cells/mm³] and nonsurvivors (0 cells/mm³; IQR, 0–30 cells/mm³; P = 0.004). Absolute eosinophil counts remained significantly lower in nonsurvivors from admission to seventh day. The 28-day mortality was significantly higher in patients with eosinopenia <40 cells/mm3 (P = 0.011). Multivariate analysis by Cox model with time-dependent covariates demonstrated that eosinophil count <40 cells/mm3 [hazard ratio (HR), 1.85; 95% confidence interval (CI), 1.01–3.42; P = 0.046], high Acute Physiology and Chronic Health Evaluation (APACHE) II score (HR, 1.08; 95% CI, 1.01–1.14; P = 0.014), high Sequential Organ Failure Assessment (SOFA) score (HR, 1.14; 95% CI, 1.03–1.25; P = 0.008), and use of mechanical ventilation (HR, 27.48; 95% CI, 12.12–62.28; P < 0.001) were independent predictors of 28-day all-cause mortality.

Conclusion

This study suggests the possibility to use eosinophil cell count at admission and during the first 7 days as a prognosis marker of mortality in medical ICU.

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Conflict of interest

The authors declare that they have no conflict of interests.

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Authors and Affiliations

  1. Medical Intensive Care Unit, Ibn Sina University Hospital, 10000, Rabat, Morocco

    Khalid Abidi, Jihane Belayachi, Youssef Derras, Mina El Khayari, Tarek Dendane, Naoufel Madani, Ibtissam Khoudri, Amine Ali Zeggwagh & Redouane Abouqal

  2. Laboratory of Biostatistics, Clinical and Epidemiological Research, Faculté de Médecine et Pharmacie, Université Mohamed V, 10000, Rabat, Morocco

    Amine Ali Zeggwagh & Redouane Abouqal

Authors
  1. Khalid Abidi
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  2. Jihane Belayachi
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  3. Youssef Derras
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  4. Mina El Khayari
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  5. Tarek Dendane
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  6. Naoufel Madani
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  7. Ibtissam Khoudri
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  8. Amine Ali Zeggwagh
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  9. Redouane Abouqal
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Corresponding author

Correspondence to Redouane Abouqal.

Additional information

Drs. Abidi Khalid and Belayachi Jihane contributed equally to the work.

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Abidi, K., Belayachi, J., Derras, Y. et al. Eosinopenia, an early marker of increased mortality in critically ill medical patients. Intensive Care Med 37, 1136–1142 (2011). https://doi.org/10.1007/s00134-011-2170-z

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  • DOI: https://doi.org/10.1007/s00134-011-2170-z

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