• Chest · Mar 2014

    Morbidity and risk factors for mortality in patients with acute exacerbation of bronchiectasis.

    • Daniel Coutinho, Margarida Dias, Maria João Oliveira, Daniel Vaz, and Maria do Céu Brito.
    • Chest. 2014 Mar 1;145(3 Suppl):430A.

    Session TitleBronchiectasisSESSION TYPE: Slide PresentationsPRESENTED ON: Saturday, March 22, 2014 at 09:00 AM - 10:00 AMPURPOSE: Evaluation of morbidity and risk factors for mortality in hospitalized patients with acute exacerbation of bronchiectasis.MethodsRetrospective study of patients admitted between 2010 and 2012 diagnosed with acute exacerbation of bronchiectasis (non cystic fibrosis) and their follow-up in the year following discharge. Data collected included: demographic variables, smoking habits, respiratory functional study, characteristics of bronchiectasis, sputum microbiological isolation, bacterial colonization, comorbidities, readmissions and mortality of the patients.ResultsWe evaluated 77 patients (77.9% men), mean age 65±15 years. The average length of stay was 11.6±7.7 days. 67.6% had smoking history, 67.5% chronic obstructive pulmonary disease (COPD) and 53.2% cardiovascular risk factors (CVRF). Regarding the type of bronchiectasis: cylindrical 54.5%, 15.6% cystic, 9.1% varicose and 20.8% multiplicity of types. 85.7% were bilateral. 42.9% of patients had bacterial isolation in sputum (57.6% Pseudomonas aeruginosa). 7.8% of patients were colonized. During the study period, 253 admissions were recorded for acute exacerbation. 66.2% of patients were readmitted (16.6% early readmission (less then 30 days) and 63.6% one-year readmission). The colonization was related to increased symptoms, decreased FEV1% predicted and longer hospitalizations. The hospital mortality was 7.8% and one-year mortality of 13.4%. The risk factors associated with mortality were: colonization (colonized vs not colonized, p=0,02, OR=16.9), presence of COPD (p=0.025, OR=8.0) and presence of CVRF (p=0.036, OR=4.0).ConclusionsPatients admitted with acute exacerbation of bronchiectasis have high number of hospital readmissions. This study shows that colonization by pathogenic microorganisms is an important risk factor for both - morbidity and mortality - of these patients.Clinical ImplicationsThe results of this study show that searching for bacterial colonization and it directed treatment can change the prognosis of these patients. The treatment of co-morbidities (COPD and CVRF) is essential to reduce the patients mortality rate.DisclosureThe following authors have nothing to disclose: Maria João Oliveira, Daniel Vaz, Daniel Coutinho, Margarida Dias, Maria do Céu BritoNo Product/Research Disclosure Information.

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