The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia [Corrigendum]

Duman D, Aksoy E, Agca MC, et al. International Journal of COPD. 2015;10(1):2469–2478.Page 2475, Table 4, the second column heading “Odds ratio” is incorrect. The correct column heading is “Hazard ratio”. Read the original article&nbsp

The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia

Dildar Duman, Emine Aksoy, Meltem Coban Agca, Nagihan Durmus Kocak, Ipek Ozmen, Ulku Aka Akturk, Sinem Gungor, Fatma Merve Tepetam, Selma Aydogan Eroglu, Selahattin Oztas, Zuhal Karakurt Sureyyapasa Chest Diseases and Thoracic Surgery Teaching Hospital, Istanbul, Turkey Background: COPD exacerbations requiring hospitalization increase morbidity and mortality. Although most COPD exacerbations are neutrophilic, approximately 10%–25% of exacerbations are eosinophilic.Aim: We aimed to evaluate mortality and outcomes of eosinophilic and non-eosinophilic COPD exacerbations and identify new biomarkers that predict survival.Methods: A retrospective observational cohort study was carried out in a tertiary teaching hospital from January 1, 2014 to November 1, 2014. All COPD patients hospitalized with exacerbations were enrolled in the study at their initial hospitalization and followed-up for 6 months after discharge. Electronic data were collected from the hospital database. Subjects’ characteristics, hemogram parameters, CRP levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-mean platelet volume ratio on admission and discharge, length of hospital stay (days), readmissions, and mortality were recorded. Patients were grouped according to peripheral blood eosinophil (PBE) levels: Group 1, >2% PBE, eosinophilic; Group 2, non-eosinophilic ≤2%. Patient survival after hospital discharge was evaluated by Kaplan–Meier survival analysis.Results: A total of 1,704 patients hospitalized with COPD exacerbation were included. Approximately 20% were classified as eosinophilic. Six-month mortality was similar in eosinophilic and non-eosinophilic groups (14.2% and 15.2%, respectively); however, the hospital stay length and readmission rate were longer and higher in the non-eosinophilic group (P<0.001 and P<0.01, respectively). CRP and NLR were significantly higher in the non-eosinophilic group (both P<0.01). The platelet-to-mean platelet volume ratio was not different between the two groups. Cox regression analysis showed that survival was negatively influenced by elevated CRP (P<0.035) and NLR (P<0.001) in the non-eosinophilic group.Conclusion: Non-eosinophilic patients with COPD exacerbations with high CRP and NLR values had worse outcomes than eosinophilic patients. PBE and NLR can be helpful markers to guide treatment decisions. Keywords: chronic obstructive pulmonary disease, exacerbation, peripheral eosinophilia, mortalit

Styela plicata: a new promising bioindicator of heavy metal pollution for eastern Aegean Sea coastal waters

As part of a research project, the concentrations of Cd, Cu, Pb, V, and Zn in the tissues of Styela plicata were investigated for the first time to determine if S. plicata is a suitable biological indicator for biomonitoring of heavy metals in eastern Aegean Sea coastal waters. To examine the relationships, heavy metal levels in suspended particulate matters (SPMs) and sediments were also determined. According to the results, the mean metal levels in SPM, sediments, and S. plicata samples could be arranged in the following order of abundance: Zn > Cu > Pb > V > Cd. As for heavy metal levels, significant positive correlations were noted between Cd-Pb, Cd-V, Cd-Zn, Cu-V, and Pb-V in SPM; Cd-Zn, Cu-Zn, Pb-Cd, Pb-Cu, and Pb-Zn in sediment; and Cu-Pb, Cu-Zn, and Pb-Zn in S. plicata samples. Positive relationships between these metals showed that they were originated from same sources and that they were associated with each other. Based on the findings, Zn, Cu, and Pb concentrations in suspended particulate matters, sediments, and S. plicata samples were generally represented with higher levels at stations that were used for boating, shipping, and related activities. As S. plicata is a strongest accumulator of V, the relatively low V levels observed in this study may indicate the lack of anthropogenic sources of this metal in the sampling stations. In conclusion, suspended particulate matter and sediment can be useful tool to detect the pollution status of the marine environment. Furthermore, the findings of this study highlighted that S. plicata is a promising alternative for the monitoring of heavy metal pollution for eastern Aegean Sea coasts