October 10, 2024
2 min learn
Key takeaways:
- Eosinophilic bronchial asthma was outlined as 300 cells/µL and better.
- ICU stays have been barely however not considerably longer for eosinophilic sufferers.
- There was no vital distinction in in-hospital mortality charges.
BOSTON — ICU sufferers with an eosinophilic bronchial asthma phenotype had longer ICU and hospital stays in contrast with sufferers with out an eosinophilic bronchial asthma sort, in response to an summary offered on the CHEST Annual Assembly.
Sergio Andres Vallejo Avila
“Our purpose with this examine was to discover whether or not particular markers like blood eosinophil counts may function early indicators of threat in critically ailing bronchial asthma sufferers,” Sergio Andres Vallejo Avila, MD, inner drugs resident at UT Well being San Antonio, informed Healio. “In the end, we hope that these early investigations will lay the groundwork for future improvement of scoring instruments to assist stratify ICU-admitted bronchial asthma sufferers based mostly on their threat.”
Eosinophilic bronchial asthma sufferers skilled considerably longer hospital stays in contrast with non-eosinophilic sufferers. Picture: Adobe Inventory
This observational examine included information from the MIMIC-IV database. It checked out grownup sufferers admitted to the ICU departments at Beth Israel Deaconess Medical Heart between 2008 and 2019 with an bronchial asthma analysis.
Based mostly on their blood eosinophil counts, these sufferers have been then stratified into two teams. The primary group included sufferers with an eosinophilic phenotype ( 300 cells/µL), and the second included sufferers with a non-eosinophilic phenotype (< 300 cells/µL).
Among the many 1,089 sufferers within the examine, 226 (20.6%) had an eosinophilic phenotype and 863 (79.2%) didn’t. Eosinophilic sufferers had a median eosinophilic rely of 440 cells/µL (interquartile vary [IQR], 363-569) whereas non-eosinophilic sufferers had a median eosinophilic rely of 90 cells/µL (IQR, 39-171).
Eosinophilic sufferers and non-eosinophilic sufferers confirmed no vital distinction in in-hospital mortality charges (11% vs 11.8%). Eosinophilic sufferers had barely however not considerably longer ICU stays (2.9 days; IQR, 1-6 vs. 2.5 days; IQR, 1.3-5.1) however considerably longer general hospital stays (median, 12 days; IQR, 7-18 vs. 9 days; IQR, 7-15; P < .001).
“Whereas the eosinophilic phenotype didn’t correlate with elevated in-hospital mortality, it was considerably related to an extended hospital size of keep,” Vallejo Avila stated. “This was an necessary discovering, because it means that though mortality charges might not differ, the eosinophilic phenotype should be a marker for extended hospitalization, which has its personal implications for well being care useful resource utilization and affected person outcomes.”
Vallejo Avila additional highlighted that the discovering that eosinophilic sufferers had longer hospital stays, however no distinction in mortality, was shocking as a result of the eosinophilic phenotype is commonly related to extra extreme bronchial asthma in outpatient settings.
“This implies that whereas mortality might not be affected, these sufferers nonetheless require extra intensive care and longer hospitalization, emphasizing the significance of phenotype-specific administration methods,” he stated.
In line with Vallejo Avila, these findings might help inform clinicians on how one can higher handle ICU-admitted bronchial asthma sufferers.
“For sufferers with the eosinophilic phenotype, realizing they’re prone to expertise longer hospital stays may immediate early, focused interventions that will scale back their general size of keep,” he stated. “Monitoring eosinophil ranges may information choices about anti-inflammatory therapies, comparable to corticosteroids or biologics, to modulate the immune response appropriately.”
Vallejo Avila added that future analysis ought to concentrate on validating these markers as impartial prognostic elements and refining them into sensible scoring techniques that can be utilized in real-time scientific decision-making.
“On a broader scale, public well being insurance policies may evolve to include these findings into ICU administration protocols for bronchial asthma sufferers, optimizing useful resource allocation and probably bettering survival charges for critically ailing bronchial asthma sufferers,” he stated.
