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Association between blood eosinophil count and risk of readmission for patients with asthma : historical cohort study

(2018) PLOS ONE. 13(7).
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Abstract
Background : Recent studies have demonstrated an association between high blood eosinophil counts and greater risk of asthma exacerbations. We sought to determine whether patients hospitalized for an asthma exacerbation were at greater risk of readmission if they had a high blood eosinophil count documented before the first hospitalization. Methods : This historical cohort study drew on 2 years of medical record data (Clinical Practice Research Datalink with Hospital Episode Statistics linkage) of patients (aged >= 5 years) admitted to hospital in England for asthma, with recorded blood eosinophil count within 1 baseline year before admission. We analyzed the association between high blood eosinophil count (>= 0.35x10(9) cells/L) and readmission risk during 1 year of follow-up after hospital discharge, with adjustment for predefined, relevant confounders using forward selection. Results : We identified 2,613 eligible patients with asthma-related admission, of median age 51 years (interquartile range, 36-69) and 76% women (1,997/2,613). Overall, 835/2,613 (32.0%) had a preadmission high blood eosinophil count. During the follow-up year, 130/2,613 patients (5.0%) were readmitted for asthma, including 55/835 (6.6%) with vs. 75/1,778 (4.2%) without high blood eosinophil count at baseline (adjusted hazard ratio [HR] 1.49; 95% CI 1.04-2.13, p = 0.029). The association was strongest in never-smokers (n = 1,296; HR 2.16, 95% CI 1.27-3.68, p = 0.005) and absent in current smokers (n = 547; HR 1.00, 95% CI 0.49-2.04, p = 0.997). Conclusions : A high blood eosinophil count in the year before an asthma-related hospitalization is associated with increased risk of readmission within the following year. These findings suggest that patients with asthma and preadmission high blood eosinophil count require careful follow-up, with treatment optimization, after discharge.
Keywords
HOSPITAL READMISSIONS, 30-DAY READMISSIONS, HEALTH-CARE, EXACERBATIONS, ADULTS, CORTICOSTEROIDS, PREDICTORS, INSIGHTS, DATABASE, OUTCOMES

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Chicago
Kerkhof, Marjan, Trung N Tran, Maarten van den Berge, Guy Brusselle, Gokul Gopalan, Rupert CM Jones, Janwillem WH Kocks, et al. 2018. “Association Between Blood Eosinophil Count and Risk of Readmission for Patients with Asthma : Historical Cohort Study.” Plos One 13 (7).
APA
Kerkhof, M., Tran, T. N., van den Berge, M., Brusselle, G., Gopalan, G., Jones, R. C., Kocks, J. W., et al. (2018). Association between blood eosinophil count and risk of readmission for patients with asthma : historical cohort study. PLOS ONE, 13(7).
Vancouver
1.
Kerkhof M, Tran TN, van den Berge M, Brusselle G, Gopalan G, Jones RC, et al. Association between blood eosinophil count and risk of readmission for patients with asthma : historical cohort study. PLOS ONE. 2018;13(7).
MLA
Kerkhof, Marjan, Trung N Tran, Maarten van den Berge, et al. “Association Between Blood Eosinophil Count and Risk of Readmission for Patients with Asthma : Historical Cohort Study.” PLOS ONE 13.7 (2018): n. pag. Print.
@article{8574508,
  abstract     = {Background : Recent studies have demonstrated an association between high blood eosinophil counts and greater risk of asthma exacerbations. We sought to determine whether patients hospitalized for an asthma exacerbation were at greater risk of readmission if they had a high blood eosinophil count documented before the first hospitalization. 
Methods : This historical cohort study drew on 2 years of medical record data (Clinical Practice Research Datalink with Hospital Episode Statistics linkage) of patients (aged {\textrangle}= 5 years) admitted to hospital in England for asthma, with recorded blood eosinophil count within 1 baseline year before admission. We analyzed the association between high blood eosinophil count ({\textrangle}= 0.35x10(9) cells/L) and readmission risk during 1 year of follow-up after hospital discharge, with adjustment for predefined, relevant confounders using forward selection. 
Results : We identified 2,613 eligible patients with asthma-related admission, of median age 51 years (interquartile range, 36-69) and 76\% women (1,997/2,613). Overall, 835/2,613 (32.0\%) had a preadmission high blood eosinophil count. During the follow-up year, 130/2,613 patients (5.0\%) were readmitted for asthma, including 55/835 (6.6\%) with vs. 75/1,778 (4.2\%) without high blood eosinophil count at baseline (adjusted hazard ratio [HR] 1.49; 95\% CI 1.04-2.13, p = 0.029). The association was strongest in never-smokers (n = 1,296; HR 2.16, 95\% CI 1.27-3.68, p = 0.005) and absent in current smokers (n = 547; HR 1.00, 95\% CI 0.49-2.04, p = 0.997). 
Conclusions : A high blood eosinophil count in the year before an asthma-related hospitalization is associated with increased risk of readmission within the following year. These findings suggest that patients with asthma and preadmission high blood eosinophil count require careful follow-up, with treatment optimization, after discharge.},
  articleno    = {e0201143},
  author       = {Kerkhof, Marjan and Tran, Trung N and van den Berge, Maarten and Brusselle, Guy and Gopalan, Gokul and Jones, Rupert CM and Kocks, Janwillem WH and Menzies-Gow, Andrew and Nuevo, Javier and Pavord, Ian D and Rastogi, Sarang and Price, David B},
  issn         = {1932-6203},
  journal      = {PLOS ONE},
  language     = {eng},
  number       = {7},
  pages        = {15},
  title        = {Association between blood eosinophil count and risk of readmission for patients with asthma : historical cohort study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0201143},
  volume       = {13},
  year         = {2018},
}

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