Eosinophils in blood or sputum. predictors of severity in asthma attack

Eosinófilos en sangre y en esputo como predictores de severidad en crisis asmática

Background: Eosinophils have been associated with severity of asthma, poor disease control, worst pulmonary function, and greater airway hyperresponsivenes, yet we don’t know how this cell behaves in Colombia and specially in our asthma clinic, at San Ignacio’s Hospital. Currently the sputum’s wright is only interpreted by the neutrophil percentage, ignoring the value of eosinophils.
Methods: A correlation study was performed in patients 16 years or older who presented to the emergency room with an asthma attack and needed hospitalization. The severity of the attack, of the eosinophils both in blood and sputum, and of the peak expiratory flow (PEF) was determined along with the length of stay (total, in wards, and in ICU) and of mechanical ventilation to determine if they related to the severity of the crisis.
Results: 169 patients were admitted in the year period with an average of 43.3 years. 56.8% and 43.2% had a severe and moderate asthma attack repectively. 84% where women. The average of eosinophils in sputum was 17.2% and 375.5 absolute cell count in blood. Average length of stay was 4.7 days. 20 patiens needed ICU with an average stay of 0.5 days in the ICU, and 0.2 days on mechanical ventilation. The mayority of patients has blood eosinophils within normal or slightly elevated values with mildly elevated sputum eosinophils. The PEF at admittance was 40% of the personal’s best. There was no correlation or agreement except for eosinophils in sputum and in blood. There was no correlation between the severity of eosinophils in sputum or in blood and length of stay, PEF or treatment received.
Conclusions: There is no correlation between the level of eosinophils in blood or in sputum and the severity of asthma attack measured in terms of length in stay, need of mechanical ventilation or the peak expiratory flow.