https://doi.org/10.4081/monaldi.2025.3298
Prognostic role of blood eosinophils in acute exacerbations of chronic obstructive pulmonary disease: systematic review and meta-analysis
Submitted: December 10, 2024
Accepted: January 21, 2025
Published: March 27, 2025
Accepted: January 21, 2025
Abstract Views: 317
PDF_EARLY VIEW: 187
SUPPLEMENTARY MATERIAL: 7
SUPPLEMENTARY MATERIAL: 7
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of hospitalization and mortality worldwide. While blood eosinophils have been suggested as a prognostic biomarker of COPD, their predictive value in AECOPD remains uncertain. This meta-analysis aims to evaluate the prognostic role of blood eosinophil counts in predicting mortality and hospital readmission in these patients. A systematic review and meta-analysis were conducted according to PRISMA guidelines. We included studies that evaluated the prognostic role of blood eosinophils in AECOPD, with predefined cut-offs. Data on mortality and readmission rates were extracted, and statistical analyses were performed to assess sensitivity, specificity, and likelihood ratios. A total of 14 studies with 23,625 patients were included. High blood eosinophil counts during AECOPD hospitalization had low sensitivity (28.1%) and specificity (66.2%) in predicting 12-month mortality and readmission. Positive and negative likelihood ratios were also suboptimal, with values of 0.8 and 1.1, respectively. Sensitivity analyses, including only high-quality studies, confirmed these findings. The results suggest that blood eosinophil counts have limited prognostic value in predicting mortality and readmission in AECOPD patients. The variability in eosinophil cut-offs and lack of consistent data across studies contribute to this limitation. Further large-scale prospective studies are needed to clarify the role of eosinophils as a prognostic marker in AECOPD. Consequently, routine measurement of blood eosinophils during acute exacerbations may not be warranted for prognostic purposes.
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How to Cite
Para, Ombretta, Giuliano Cassataro, Chiara Fantoni, Lorenza Bertù, Claudia Tieri, Lorenzo Caruso, Sara Rotunno, and Francesco Dentali. 2025. “Prognostic Role of Blood Eosinophils in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2025.3298.
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