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Background: Chronic obstructive airway disease (COAD) is a neutrophilic inflammatory disease but can transform into eosinophilic inflammation during exacerbation usually reflected in increase sputum eosinophil count. Peripheral blood eosinophilia (PBE) has been reported in some studies to be a good marker of sputum eosinophil. Eosinophilia either in the sputum or peripheral blood has also been reported to be associated with increased risk of infective exacerbation and increased response to inhale corticosteroid (ICS) in patients with COAD. The aim of this study is to determine the relationship of post admission PBE counts and the outcomes in the treatment of acute infective exacerbation of COAD. Methods: This is a prospective study of patients with COAD admitted with infective exacerbation between June to September 2016 and followed up till January 2017. The PBE of the patients were estimated on admission and on discharge. The patients were classified into eosinophilic and none-eosinophilic COAD on discharge based on the level of blood eosinophil count of above or below 0.3 × 109/l respectively. Means and student t test were used to describe the none categorical data and odd ratio (OR) was used to determine the risk of readmission. Results: On admission 26.7% (16) had eosinophilic COAD (mean PBE count of 0.545 × 109/l ± 0.339 × 109/l) while 73.3% (44) had none-eosinophilic COAD (0.0454 ×109/l ± 0.0663 × 109/l). There was no difference in the length of hospital stay (LOHS) between patients with PBE count of ≥ 0.3 × 109/l (5.36 ± 6.26 days) and those with ≤ 0.2 × 109/l (6.26 ± 4.57 days) on admission (t=-0.48848, p =0.314). Irrespective of the PBE on admission most of the patients (95.3%) received parenteral (oral or intravenous) corticosteroid as part of their treatment regimen. On discharge most patients (96.2%) had low mean PBE of 0.078 ± 0.084 × 109/l while only 3.8% had a mean PBE count of 0.400 ± 0.141 × 109/l. Those with PBE of ≥ 0.3 × 109/l on discharge are at a slightly higher risk of readmission than those with count of ≤ 0.2 × 109/l with odd ratio of 1.7 (CI=95%). 50% of those with PBE > 0.3 × 109/l and 37.5% of those with count ≤ 0.2 × 109/l were readmitted at least once during the study period. The prescription of ICS or lack of it on discharge does not have significant influence on the risk of readmission post treatment for AECOAD with OR = 0.7 (CI=95%). Only 38.7% of those discharged on ICS and 64% of those who were not given ICS on discharge were re-admitted at least once in the study period. Conclusion: The PBE count on admission had no significant impact on the LOHS and COAD Patients with PBE ≥ 0.3 × 109/ul at discharge post treatment for AECOAD had marginal significant risk of at least one readmission in 6 months post discharge with OR of 1.7. While the use of ICS post discharge had no impact on the rate of readmission. Correspondence to: Tunde Maiyaki Ibrahim, Department of Medicine, Goulburn Valley Base Hospital, Graham Street Shepparton, Victoria, Australia, E-mail: imaiyaki@yahoo.com Received: February 01, 2018; Accepted: February 13, 2018; Published: February 26, 2018 Introduction COAD is a neutrophilic inflammatory disease but can transform into eosinophilic inflammation during exacerbation. This is usually reflected in increase sputum eosinophil count. Peripheral Blood Eosinophilia (PBE) has been reported to be a good marker of sputum eosinophil. And eosinophilia either in the sputum or peripheral blood has been reported to be associated with increased risk of acute infective exacerbation and increases response to inhale corticosteroid (ICS) in patients with COAD [1-3]. The aim of this study is to determine the relationship of post admission PBE counts and the outcomes in the treatment of acute infective exacerbation of COAD.

clinical microbiology and infectious diseases

The impact of high peripheral blood eosinophil count during treatment of infective COAD exacerbation on the length of hospital stay and the rate of readmission