Obstructive Lung Diseases |

Morbidity and Risk Factors for Mortality in Patients With Acute Exacerbation of Bronchiectasis FREE TO VIEW

Maria João Oliveira, MS; Daniel Vaz, MS; Daniel Coutinho, MS; Margarida Dias, MS; Maria do Céu Brito, MS
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Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal

Chest. 2014;145(3_MeetingAbstracts):430A. doi:10.1378/chest.1834963
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SESSION TITLE: Bronchiectasis

SESSION TYPE: Slide Presentations

PRESENTED ON: Saturday, March 22, 2014 at 09:00 AM - 10:00 AM

PURPOSE: Evaluation of morbidity and risk factors for mortality in hospitalized patients with acute exacerbation of bronchiectasis.

METHODS: Retrospective 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.

RESULTS: We 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).

CONCLUSIONS: Patients 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 IMPLICATIONS: The 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.

DISCLOSURE: The following authors have nothing to disclose: Maria João Oliveira, Daniel Vaz, Daniel Coutinho, Margarida Dias, Maria do Céu Brito

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