Clinical Characteristics, Outcomes, and Predictors of Severity in Acute Eosinophilic Pneumonia (AEP): A Meta-analysis
Notice bibliographique
Résumé
Background: Acute eosinophilic pneumonia (AEP) is a rare, potentially life-threatening respiratory illness characterized by rapid onset of symptoms, diffuse pulmonary infiltrates, and marked eosinophilia in bronchoalveolar lavage (BAL) fluid. This meta-analysis aimed to synthesize published data to provide robust estimates of clinical characteristics, outcomes, and predictors of severity in patients diagnosed with AEP. Methods: A systematic literature search was conducted in PubMed, Embase, Scopus, and Web of Science databases for studies published between January 1st, 2014, and December 31st, 2024. Inclusion criteria specified observational studies reporting on clinical features, diagnostic findings, and clinical outcomes in patients meeting standard AEP diagnostic criteria. Data extraction and quality assessment (using the Newcastle-Ottawa Scale) were performed independently by two reviewers. Pooled proportions and means were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic. Potential predictors of MV requirement were evaluated by pooling odds ratios (ORs) where available. Results: Six studies met the inclusion criteria, comprising a total of 315 patients diagnosed with AEP. The pooled mean age was 29.5 years (95% CI: 26.8-32.2), with a predominance of male patients (pooled proportion: 78%, 95% CI: 71%-84%, I²=45%). A strong association with recent smoking initiation or change was confirmed (pooled proportion: 85%, 95% CI: 78%-91%, I²=55%). Common presenting symptoms included dyspnea (95%), fever (92%), and cough (88%). While peripheral eosinophilia was variable at presentation (pooled mean: 650 cells/µL, 95% CI: 450-850), BAL eosinophilia was markedly elevated (pooled mean percentage: 42%, 95% CI: 37%-47%, I²=78%). The pooled proportion of patients requiring mechanical ventilation was substantial (38%, 95% CI: 30%-46%, I²=68%). Overall in-hospital mortality remained low (pooled proportion: 1.8%, 95% CI: 0.5%-3.5%, I²=0%). Significant heterogeneity was observed for most pooled estimates. Factors significantly associated with an increased likelihood of requiring mechanical ventilation included a shorter time from symptom onset to presentation (<3 days) (pooled OR: 3.1, 95% CI: 1.8-5.3, I²=35%) and higher initial C-reactive protein (CRP) levels (analyzed descriptively due to varied reporting). Conclusion: This meta-analysis confirms that AEP typically affects young male smokers and presents acutely with severe respiratory symptoms. Despite variable peripheral eosinophilia, marked BAL eosinophilia is a diagnostic hallmark. A significant proportion requires mechanical ventilation, highlighting the potential severity. However, mortality is low with appropriate treatment, typically corticosteroids. Very acute onset and higher inflammatory markers may predict the need for ventilatory support, warranting close monitoring in these patients. Further research with standardized reporting is needed to refine predictors and optimize management strategies.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».