Pulmonary Physiology |

Clustering Non-Cystic Fibrosis Bronchiectasis (NCFBE) Patients According to Clinical Features FREE TO VIEW

Stefano Aliberti; Paola Faverio; Sara Lonni; James Chalmers; Angelo Bignamini; Giulia Suigo; Giulia Bonaiti; Sara Annoni; Alberto Pesci
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Health Science Department, Respiratory Unit, University of Milan Bicocca, Azienda Ospedaliera San Gerardo, Milan, Italy

Chest. 2014;146(4_MeetingAbstracts):718A. doi:10.1378/chest.1993377
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SESSION TITLE: Cystic Fibrosis/Bronchiectasis Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: NCFBE represents a heterogeneous disease. However, in clinical practice, patients share common clinical features and could be clustered according to history, signs and symptoms. The aim of this study was to identify distinct clinical phenotypes of NCFBE patients according to clinical variables easily detectable during visits.

METHODS: This was an observational, prospective study of consecutive NCFBE patients attending the outpatient bronchiectasis clinic at the San Gerardo University Hospital in Monza, Italy, during 2013. A two-step cluster analysis was performed after having identified four key variables: dyspnea (evaluated by Medical Research Council -MRC- scale), daily sputum production, number of exacerbations, episodes of recurrent pneumonia (at least 1/year during the prior 3 years).

RESULTS: A total of 161 patients (median age: 69 years; 42% males) were enrolled. Five clusters were identified (silhouette measure of cohesion and separation: 0.75; dimension rate: 4.00): 1) Mildly symptomatic (37%), patients without sputum, neither dyspnea nor frequent exacerbations; 2) Only sputum (24%), patients with only daily sputum; 3) Frequent exacerbators (11%), patients with daily sputum and ≥ than 3 exacerbations per year; 4) Poor performance (19%), patients with daily sputum, dyspnea (MRC 4-5) and ≥ than 3 exacerbations per year; 5) Pneumonitics (9%), patients with only recurrent pneumonias. The number of patients with at least one hospitalization per year due to exacerbation was higher in the Poor Performance cluster (55%) than the other clusters (10% in the Mildly symptomatic, 16% in the Only sputum, 22% in the Frequent exacerbators, and 27% in the Pneumonitics cluster, respectively) (p<0.001).

CONCLUSIONS: Identifying clinical phenotypes in NCFBE could be helpful from both a clinical (targeting treatment in order to improve outcomes) and a research (orienting “-omics” research) point of view.

CLINICAL IMPLICATIONS: Patients with the same clinical phenotype may benefit from similar therapeutic measures and share a similar clinical course.

DISCLOSURE: The following authors have nothing to disclose: Stefano Aliberti, Paola Faverio, Sara Lonni, James Chalmers, Angelo Bignamini, Giulia Suigo, Giulia Bonaiti, Sara Annoni, Alberto Pesci

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