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Published on: March 17, 2014
Factors Associated With Long-Term Mortality in Bronchiectasis
Grace Oscullo1, Raúl Méndez1, Casilda Olveira2
1Servicio de Neumología e Instituto de Investigación La Fe (IISLAFE), Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
Introduction:
There are scarce data on long-term mortality in bronchiectasis in studies including a high number of bronchiectasis subjects. The objective of this study was to investigate risk factors of all-cause mortality in a large series of bronchiectasis patients with a long follow-up.
Methods:
Historical cohort series from the Spanish Registry of Bronchiectasis in 2057 patients with a median follow-up of 84 (IQR: 72-102) months. A wide set of data from all the dimensions of bronchiectasis (general, clinical, etiological, complementary test, peripheral biomarkers, functional, microbiological, and therapeutic) was collected. 408 patients died during follow-up. Multivariable Cox survival analysis was used.
Results:
Thirteen variables (Condition/HR): COPD/3.16; Chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA)/2.57; peripheral neutrophilia (>80%)/2.53; Previous and follow-up hospitalization rate/2.01 and 1.93 respectively; Previous and follow-up exacerbation rate/1.05 and 2.01 respectively; Charlson index/1.24; age/1.06; Baseline FEV1%pred/0.98; Previous pneumonia episodes/1.04 and dyspnea/1.16 were independently associated with greater mortality. FACED, E-FACED and BSI were analyzed separately, with HR of 2.3, 2.2 and 1.7, respectively.
Conclusions:
The presence of COPD, CBI by PA, peripheral neutrophilia, and hospitalizations were the four most important variables independently associated with greater long-term mortality in bronchiectasis.
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