Analysis of the factors related to mortality in patients with bronchiectasis

Önen, Zeynep Pınar; Gülbay, Banu Eriş; Şen, Elif; Yildiz, Öznur Akkoca; Saryal, Sevgi; Acican, Turan; Karabıyıkoğlu, Gülseren

doi:10.1016/j.rmed.2007.02.002

Cited by 118 publications

(115 citation statements)

References 24 publications

(35 reference statements)

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“…Independent predictors of mortality in this cohort included age, P. aeruginosa colonization, pulmonary function, and the St. George's respiratory questionnaire, all of which support the findings of the present study (26). Onen and colleagues reported data from 98 patients with bronchiectasis in which there were 16 deaths and found age, BMI, and severity of dyspnea to be the strongest predictors of mortality (27). This study has limitations: the derived score is relatively complex, awarding different point values for each of the predictors and including multiple predictors.…”

Section: Discussionsupporting

confidence: 86%

The Bronchiectasis Severity Index. An International Derivation and Validation Study

Chalmers

Goeminne²,

Aliberti

et al. 2014

Am J Respir Crit Care Med

843

836

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Rationale: There are no risk stratification tools for morbidity and mortality in bronchiectasis. Identifying patients at risk of exacerbations, hospital admissions, and mortality is vital for future research.Objectives: This study describes the derivation and validation of the Bronchiectasis Severity Index (BSI).Methods: Derivation of the BSI used data from a prospective cohort study (Edinburgh, UK, 2008 enrolling 608 patients. Cox proportional hazard regression was used to identify independent predictors of mortality and hospitalization over 4-year follow-up. The score was validated in independent cohorts from Dundee, UK (n = 218); Leuven, Belgium (n = 253); Monza, Italy (n = 105); and Newcastle, UK (n = 126).Measurements and Main Results: Independent predictors of future hospitalization were prior hospital admissions, Medical Research Council dyspnea score greater than or equal to 4, FEV 1 , 30% predicted, Pseudomonas aeruginosa colonization, colonization with other pathogenic organisms, and three or more lobes involved on high-resolution computed tomography. Independent predictors of mortality were older age, low FEV 1 , lower body mass index, prior hospitalization, and three or more exacerbations in the year before the study. The derived BSI predicted mortality and hospitalization: area under the receiver operator characteristic curve (AUC) 0.80 (95% confidence interval, 0.74-0.86) for mortality and AUC 0.88 (95% confidence interval, 0.84-0.91) for hospitalization, respectively.There was a clear difference in exacerbation frequency and quality of life using the St. George's Respiratory Questionnaire between patients classified as low, intermediate, and high risk by the score (P , 0.0001 for all comparisons). In the validation cohorts, the AUC for mortality ranged from 0.81 to 0.84 and for hospitalization from 0.80 to 0.88. Conclusions:The BSI is a useful clinical predictive tool that identifies patients at risk of future mortality, hospitalization, and exacerbations across healthcare systems.

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Section: Discussionsupporting

confidence: 86%

The Bronchiectasis Severity Index. An International Derivation and Validation Study

Chalmers

Goeminne²,

Aliberti

et al. 2014

Am J Respir Crit Care Med

843

836

View full text Add to dashboard Cite

show abstract

“…Various studies on patients with non-CF bronchiectasis have demonstrated the relationship of both these variables with an increase in mortality [12,13]. The high colinearity between FEV1 and forced vital capacity made it possible to choose FEV1 to represent the patient's functional state, as this is the variable most commonly used in the evaluation of airflow obstruction, the most common functional pattern in patients with bronchiectasis [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Several single variables have been used to predict key outcomes of bronchiectasis, such as decline in lung function, various clinical parameters, radiological extension and the presence of chronic colonisation by Pseudomonas aeruginosa [9,12,13]. However, as with other airways diseases, the severity and prognosis of bronchiectasis cannot be adequately defined with one single variable.…”

Section: Introductionmentioning

confidence: 99%

Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score

et al. 2013

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Bronchiectasis is a multidimensional disease and, therefore, its severity or prognosis cannot be adequately quantified by analysing one single variable. The objective of the present study was to develop a multidimensional score that classifies the severity of bronchiectasis according to its prognosis. This is an observational multicentre study including 819 patients diagnosed with non-cystic fibrosis bronchiectasis using high-resolution computed tomography. 397 subjects were selected at random to construct the score while the remaining 422 were used for its validation. The outcome was 5-year all-cause mortality after radiological diagnosis. A logistic regression analysis was used to select the variables included in the final score.The final seven-point score incorporated five dichotomised variables: forced expiratory volume in 1 s % predicted (F, cut-off 50%, maximum value 2 points); age (A, cut-off 70 years, maximum value 2 points); presence of chronic colonisation by Pseudomonas aeruginosa (C, dichotomic, maximum value 1 point); radiological extension (E, number of lobes affected, cut-off two lobes, maximum value 1 point); and dyspnoea (D, cut-off grade II on the Medical Research Council scale, maximum value 1 point) to construct the FACED score. The validation cohort confirmed the score's validity.We conclude that this easy-to-use multidimensional grading system proved capable of accurately classifying the severity of bronchiectasis according to its prognosis. @ERSpublications An easy-to-use multidimensional grading system accurately classifies bronchiectasis severity according to prognosis

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“…Few studies have reported the outcomes of adult non-CF bronchiectasis (6,(14)(15)(16). Two severity scoring systems were recently reported as useful to predict mortality in patients with bronchiectasis, but are thought to be too complicated for use in daily clinical practice (6,7).…”

Section: Discussionmentioning

confidence: 99%

“…Chronic alveolar hypoxia results in sustained pulmonary vasoconstriction and pulmonary vascular remodeling, and subsequent onset and progression of hypoxia-induced pulmonary hypertension (22). Onen et al found that hypoxemia was more closely correlated with mortality in patients with bronchiectasis (14). Dupont et al reported that long-term oxygen therapy was an independent factor for survival of patients with bronchiectasis after the first admission to an intensive care unit (23).…”

Section: Correlations Between 6mwt-derived Variables and 6-year Survivalmentioning

confidence: 99%

Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis

et al. 2017

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Background: Previous surveillance methods to monitor the prognoses of patients with bronchiectasis are too complex for use in daily practice. The 6-minute walk test (6MWT) is a simple exercise test to predict the prognosis of chronic obstructive airway disease and numerous chronic lung diseases, including idiopathic pulmonary fibrosis. No studies have investigated exercise-induced oxygen desaturation (EID) and distancesaturation product (DSP) of 6MWT to predict the prognoses of patients with bronchiectasis. Methods: This was a prospective study to identify correlations between variables of 6MWT and mortality in patients with bronchiectasis over a 6-year period. The study cohort included 69 patients with stable noncystic fibrosis (non-CF) bronchiectasis who were regularly evaluated for functional status via 6-minute walk distance (6MWD), spirometry, BODE index, EID, and DSP.Results: Of the 69 patients, 9 (13%) died and 60 (87%) survived during the 6-year follow-up period. Multivariate analysis showed that DSP (OR =0.983; P=0.001) was the best parameter of 6MWT to predict mortality. Patients with a lower DSP of <280 m% were at a 66.5-fold greater risk (OR =66.5; 95% CI: 9.4-469.2) of 6-year mortality compared with those with DSP >280 m% (P<0.001).Conclusions: DSP is a simple parameter to predict 6-year mortality in patients with non-CF bronchiectasis.

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Analysis of the factors related to mortality in patients with bronchiectasis

Abstract: These results suggest that high BMI, regular vaccination and scheduled visits may have beneficial effects on the survival of bronchiectasis. Besides, presence of hypoxemia, hypercapnia, dyspnea level and radiographic extent were more closely correlated with mortality.

Cited by 118 publications

References 24 publications

The Bronchiectasis Severity Index. An International Derivation and Validation Study

The Bronchiectasis Severity Index. An International Derivation and Validation Study

Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score

Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis

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