The factors affecting survival in patients with bronchiectasis

The factors affecting survival in patients with bronchiectasis

Background/aim: There is limited information about the rate and modifiers of mortality in noncystic fibrosis bronchiectasis. Materials and methods: This study enrolled a total of 56 bronchiectasis patients. Patients body mass index, smoking habit, previous therapies, comorbid disorders, history of vaccination, bronchiectasis type and radiological extent, arterial blood gas analysis, respiratory function tests, and laboratory results were recorded. Results: After a follow-up of 65.38 ± 18.62 months the overall mortality rate was 35.7%. The mean survival duration was 46.42 ± 8.25 months. Advanced age significantly increased mortality (HR: 2.031; CI: 0.991 4.072, P = 0.035). A significant correlation was found between mortality rate and the partial oxygen pressure level (HR: 0.886 (CI: 0.817 0.960); P = 0.039). Pulmonary artery pressure was directly proportional to mortality rate (HR: 9.015 (CI: 3.272 94.036); P = 0.03). There was also a significant correlation between Pseudomonas aeruginosa proliferation in sputum and mortality (HR: 7.014 (CI: 2.812 17.962); P = 0.00). Comorbidities increased mortality (HR: 1.984 (CI: 0.972 2.996); P = 0.04). Conclusion: Bronchiectasis is a disease with high mortality. Advanced age, comorbid conditions, reduced partial oxygen pressure, pulmonary hypertension, and Pseudomonas aeruginosa proliferation in sputum increase its mortality rate.

___

  • 1. Goeminne P, Dupont L. Non-cystic fibrosis bronchiectasis: diagnosis and management in 21st century. Postgrad Med J 2010; 86: 493-501.
  • 2. Loebinger MR, Wells AU, Hansell DM, Chinyanganya N, Devaraj A, Meister M, Wilson R. Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. Eur Respir J 2009; 34: 843-849.
  • 3. Finklea JD, Khan G, Thomas S, Song J, Myers D, Arroliga AC. Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis. Respir Med 2010; 104: 816-821.
  • 4. Tsang KW, Tipoe GL. Bronchiectasis: not an orphan disease in the East. Int J Tuberc Lung Dis 2004; 8: 691-702.
  • 5. Habesoglu MA, Ugurlu AO, Eyuboglu FO. Clinical, radiologic, and functional evaluation of 304 patients with bronchiectasis. Ann Thorac Med 2011; 6: 131-136.
  • 6. Habesoglu MA, Tercan F, Ozkan U, Fusun EO. Effect of radiological extent and severity of bronchiectasis on pulmonary function. Multidiscip Respir Med 2011; 6: 284-290.
  • 7. Goeminne PC, Nawrot TS, Ruttens D, Seys S, Dupont LJ. Mortality in non-cystic fibrosis bronchiectasis: a prospective cohort analysis. Respir Med 2014; 108: 287-296.
  • 8. Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, Poppelwell L, Sali W, Pesci A, Dupont LJ et al. The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med 2014; 189: 576- 585.
  • 9. Poppelwell L, Chalmers JD. Defining severity in non-cystic fibrosis bronchiectasis. Expert Rev Respir Med 2014; 8: 249- 262.
  • 10. Loebinger MR, Wilson R. Pharmacotherapy for bronchiectasis. Expert Opin Pharmacother 2007; 8: 3183-3193.
  • 11. Papi A, Bellettato CM, Braccioni F, Romagnoli M, Casolari P, Caramori G, Fabbri LM, Johnston SL. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med 2006; 173: 1114- 1121.
  • 12. Bedi P, Sidhu MK, Donaldson LS, Chalmers JD, Smith MP, Turnbull K, Pentland JL, Scott J, Hill AT. A prospective cohort study of the use of domiciliary intravenous antibiotics in bronchiectasis. NPJ Prim Care Respir Med 2014; 24: 14090.
  • 13. Haworth CS, Foweraker JE, Wilkinson P, Kenyon RF, Bilton D. Inhaled colistin in patients with bronchiectasis and chronic Pseudomonas aeruginosa infection. Am J Respir Crit Care Med 2014; 189: 975-982.
  • 14. Bhalla M, Turcios N, Aponte V, Jenkins M, Leitman BS, McCauley DI, Naidich DP. Cystic fibrosis: scoring system with thin-section CT. Radiology 1991; 179: 783-788.
  • 15. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases 1987; 40: 373-383.
  • 16. Pasteur MC, Bilton D, Hill AT; British Thoracic Society Bronchiectasis non-CF Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax 2010; 65: 1-58.
  • 17. Onen ZP, Gulbay BE, Sen E, Yıldız OA, Saryal S, Acican T, Karabiyikoglu G. Analysis of the factors related to mortality in patients with bronchiectasis. Respir Med 2007; 101: 1390-1397.
  • 18. Dupont M, Gacouin A, Lena H, Lavoue S, Brinchault G, Delaval P, Thomas R. Survival of patients with bronchiectasis after the first ICU stay for respiratory failure. Chest 2004; 125: 1815-1820.
  • 19. Keistinen T, Saynajakangas O, Tuuponen T, Kivela SL. Bronchiectasis: an orphan disease with a poorly-understood prognosis. Eur Respir J 1997; 10: 2784-2787.
  • 20. McDonnell MJ, Ahmed M, Das J, Ward C, Mokoka M, Breen DP, O’Regan A, Gilmartin JJ, Bruzzi J, Rutherford RM. Hiatal hernias are correlated with increased severity of non-cystic fibrosis bronchiectasis. Respirology 2015; 20: 749-757.
  • 21. Lee AL, Button BM, Denehy L, Roberts SJ, Bamford TL, Ellis SJ, Mu FT, Heine RG, Stirling RG, Wilson JW. Proximal and distal gastro-oesophageal reflux in chronic obstructive pulmonary disease and bronchiectasis. Respirology 2014; 19: 211-217.
  • 22. Chalmers JD, McHugh BJ, Docherty C, Govan JR, Hill AT. Vitamin-D deficiency is associated with chronic bacterial colonisation and disease severity in bronchiectasis. Thorax 2013; 68: 39-47.
  • 23. Borekci S, Halis AN, Aygun G, Musellim B. Bacterial colonization and associated factors in patients with bronchiectasis. Ann Thorac Med 2016; 11: 55-59.
  • 24. Davies G, Wells AU, Doffman S, Watanabe S, Wilson R. The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis. Eur Respir J 2006; 28: 974-979.
  • 25. Wilson CB, Jones PW, O’Leary CJ, Hansell DM, Cole PJ, Wilson R. Effect of sputum bacteriology on the quality of life of patients with bronchiectasis. Eur Respir J 1997; 10: 1754-1760.
  • 26. Martinez-Garcia MA, Soler-Cataluna JJ, Perpina-Tordera M, Roman-Sanchez P, Soriano J. Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis. Chest 2007; 132: 1565-1572.
  • 27. Reiff DB, Wells AU, Carr DH, Cole PJ, Hansell DM. CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types. AJR Am J Roentgenol 1995; 165: 261-267.