Value of eosinophils for prognosis of ventilator-associated pneumonia

Lin Xihu; Dong Xinling

doi:10.3760/cma.j.issn.1673-4777.2016.02.017

Abstract：Objective To evaluate the prognosis value of eosinophila (EO)in patient with ventilator associated pneumonia (VAP).Methods Totally 53 VAP patients with duration ≥ 28 days from December 2013 to April 2015 were enrolled and divided into death group (30 cases) and survival group (23 cases) according to the prognosis.The level of EO on the day of diagnose,1-7,10,14,17,20 d after diagnosis and the last 3 days before cut-off were compared between groups.Results At all the time points,the EO value in death group were all significantly lower than those in survival group [(31 ±24) × 106/L vs (49 ±36) × 106/L,(29 ±24) × 106/L vs (53 ±37) × 106/L,(33 ±25) × 106/L vs (53 ±44) × 106/L,(32 ± 26) × 106/L vs (48 ±37) × 106/L,(27 ±21) ×106/L vs (54 ±42) × 106/L,(27 ±21) × 106/L vs (54 ±40) × 106/L,(23 ± 17) × 106/L vs (64 ±46) × 106/L,(23 ±20) ×106/L vs (65 ±47) × 106/L,(21 ± 18) × 106/L vs (68 ±39) × 106/L,(22 ± 18) × 106/L vs (66 ± 40) × 106/L,(20 ±21) × 106/L vs (70 ±36) × 106/L,(23 ± 19) × 106/L vs (74 ± 31) × 106/L,(17 ± 16) × 106/L vs (85 ±34) × 106/L,(19 ± 16) × 106/L vs (79 ±26) × 106/L,(10 ± 12) × 106/L vs (91 ±23) × 106/L] (P ＜0.05),and the difference increased along with the course of disease.On the day of diagnosis,during the first 7 days of the course,during the first 10 days of the course and the whole course,the cut-off value of EO in predicting death was 55 × 106/L,55 × 106/L,56 × 106/L,33 × 106/L,respectively,with sensitivity of 0.435,0.478,0.478,0.913 and specificity of 0.800,1.000,1.000,0.867.Conclusion EO is correlated with the prognosis of VAP and can be used as a predictive indicator of prognosis;after 10 days of treatment with antibiotic,the therapy regimen should be adjusted in time if EO ＜ 56 × 106/L indicating poor effect.