Absolute eosinophil count as a reliable prognostic marker in patients with perforative peritonitis: a prospective study
DOI:
https://doi.org/10.18203/2349-2902.isj20190377Keywords:
Absolute eosinophil count, Perforative peritonitisAbstract
Background: The aims of the study were to find whether a decrease in absolute eosinophil count was a reliable prognostic marker in patients with perforative peritonitis and to determine whether the levels of Absolute eosinophil count had any correlation with the type of perforation.
Methods: A total of 104 patients with perforative peritonitis presented consecutively to Madras Medical College, Rajiv Gandhi Government General Hospital from October 2017 to October 2018 were chosen and were allocated into two groups based on the outcome as mortality or survival. 88 patients were in the survival group and 16 patients were in the mortality group. The Absolute eosinophil count distribution in both these groups were recorded along with the type of perforation.
Results: Data were processed using SPSS software. All values were expressed as mean±standard deviation / median. Comparison of absolute eosinophil count between the two groups was done using student ‘t’ test and prognostic accuracy of the parameters were done using ROC curve analysis. It was found that a decrease in absolute eosinophil count was associated with adverse outcome in perforative peritonitis patients.
Conclusions: From this study, we conclude that Absolute Eosinophil Count is a reliable marker of survival. It allows timely identification of high-risk patients and can be used as a marker for risk stratification and hence can be considered a reliable prognostic marker in perforative peritonitis patients. It can also be concluded that there is no correlation between the Absolute eosinophil count levels and the type of perforation.
References
Jain NK, Jain MG, Maini S, Khobragade V. A study of clinical profile and management of perforation peritonitis in a tertiary health centre located in Central India. Int Surg J. 2017 Feb 25;4(3):981-7.
Merino CA, Martínez FT, Cardemil F, Rodríguez JR. Absolute eosinophils count as a marker of mortality in patients with severe sepsis and septic shock in an intensive care unit. J Critical Care. 2012 Aug 1;27(4):394-9.
Gil H, Magy N, Mauny F, Dupond JL. Value of eosinopenia in inflammatory disorders: an" old" marker revisited. Internal Med J. 2003 Jul;24(7):431-5.
Abidi K, Khoudri I, Belayachi J, Madani N, Zekraoui A, Zeggwagh AA, et al. Eosinopenia is a reliable marker of sepsis on admission to medical intensive care units. Critical Care. 2008 Apr;12(2):R59.
Abidi K, Belayachi J, Derras Y, El Khayari M, Dendane T, Madani N, et al. Eosinopenia, an early marker of increased mortality in critically ill medical patients. Intensive care medicine. 2011 Jul 1;37(7):1136-42.
Krause JR, Boggs DR. Search for eosinopenia in hospitalized patients with normal blood leukocyte concentration. Am J Hematol. 1987 Jan;24(1):55-63.
Khosla SN, Anand A, Singh U, Khosla A, Haematological profile in typhoid fever. Trop Doct. 1995 Oct;25(4):156-8.
Shaaban H, Daniel S, Sison R, Slim J, Perez G. Eosinopenia: Is it a good marker of sepsis in comparison to procalcitonin and C-reactive protein levels for patients admitted to a critical care unit in an urban hospital?. J Critical Care. 2010 Dec 1;25(4):570-5.
Holland M, Alkhalil M, Chandromouli S, Janjua A, Babores M. Eosinopenia as a marker of mortality and length of stay in patients admitted with exacerbations of chronic obstructive pulmonary disease. Respirol. 2010 Jan;15(1):165-7.
López ID, Sánchez MC, Rodríguez SV, Raigal AC, López PR, Velasco AR, et al. Evaluation of eosinopenia as an infection marker in critical care patients. Medicina Intensiva. 2010 May;34(4):246-53.
Bass DA, Gonwa TA, Szejda P, Cousart MS, DeChatelet LR, McCall CE. Eosinopenia of acute infection: production of eosinopenia by chemotactic factors of acute inflammation. J Clin Investigation. 1980 Jun 1;65(6):1265-71.
Montesanti M, Testa G, Biagi C, Bartolini F. Trend of circulating eosinophils in healthy children and children suffering from infectious diseases. A retrospective study. Minerva Pediatr. 1997 May;49(5):179-86.
Garnacho-Montero J, Huici-Moreno MJ, Gutiérrez-Pizarraya A, López I, Márquez-Vácaro JA, Macher H, et al. Prognostic and diagnostic value of eosinopenia, C-reactive protein, procalcitonin, and circulating cell-free DNA in critically ill patients admitted with suspicion of sepsis. Critical care. 2014 Jun;18(3):R116.
Dorizzi RM, Polati E, Sette P, Ferrari A, Rizzotti P, Luzzani A. Procalcitonin in the diagnosis of inflammation in intensive care units. Clin Biochem. 2006;39(12):1138-43.
Schuetz P, Christ-Crain M, Muller B. Procalcitonin and other biomarkers for the assessment of disease severity and guidance of treatment in bacterial infections. Advances Sepsis. 2008;6(3):82-9.
Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret GY. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Critical Care Med. 2006 Jul 1;34(7):1996-2003.
Jagdeesh TS, Mishra A, Saxena A, Sharma D. Eosinopenia as a prognostic marker in patients with peritonitis. ISRN Infectious Dis. 2012 Aug 28;2013.