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Published in: Lung 6/2018

01-12-2018 | AIRWAY DISEASE

Prognostic Factors in Adult Patients with Non-Cystic Fibrosis Bronchiectasis

Authors: Betina Charvet Machado, Patrícia Santos Jacques, Louise Piva Penteado, Paulo de Tarso Roth Dalcin

Published in: Lung | Issue 6/2018

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Abstract

Background

Non-cystic fibrosis bronchiectasis (NCFB) is a heterogeneous disease. There are few studies about prognostic factors in these patients. Our study aims to assess mortality rates and related factors in a cohort of patients and test the ability of the BSI and FACED scores in predicting mortality in this cohort.

Methods

This was a prospective cohort analysis of 70 patients with NCFB recruited from May 2008 to August 2010. At baseline, patients underwent clinical evaluation, pulmonary function tests, 6-min walk test, and quality of life assessment. Outcomes were defined as favorable (survivors) and unfavorable (survivors who underwent lung transplantation and death from all causes). Baseline records provided data for determination of BSI and FACED.

Results

Twenty-seven patients (38.57%) died and 1 (1.43%) underwent lung transplantation. Mean time for occurrence of unfavorable outcomes was 74.67 ± 4.00 months. Main cause of death was an acute infectious exacerbation of bronchiectasis (60.7). Cox regression identified age (p = 0.035; HR 1.04; CI 1.01–1.08), FEV1 % of predicted (p = 0.045; HR 0.97; CI 0.93–0.99), and MEP (p = 0.016; HR 0.96; CI 0.94–0.99) as independent predictors of unfavorable outcomes. FACED was better at predicting unfavorable outcomes in our cohort (log-rank test, FACED p = 0.001 and BSI p = 0.286). In ROC analysis, both scores were similar in predicting unfavorable outcomes (BSI 0.65; FACED 0.66).

Conclusions

Older age, lower FEV1 % of predicted, and lower MEP were independently linked to unfavorable outcomes. FACED and BSI were not accurate in predicting mortality in our cohort.
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Literature
2.
go back to reference Murray MP, Govan JR, Doherty CJ, Simpson AJ, Wilkinson TS, Chalmers JD, Greening AP, Haslett C, Hill AT (2011) A randomized controlled trial of nebulized gentamicin in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 183(4):491–499CrossRef Murray MP, Govan JR, Doherty CJ, Simpson AJ, Wilkinson TS, Chalmers JD, Greening AP, Haslett C, Hill AT (2011) A randomized controlled trial of nebulized gentamicin in non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 183(4):491–499CrossRef
3.
go back to reference Pasteur MC, Bilton D, Hill AT (2010) british thoracic society guideline for non-CF bronchiectasis. Thorax 65(Suppl 1):i1–i58CrossRef Pasteur MC, Bilton D, Hill AT (2010) british thoracic society guideline for non-CF bronchiectasis. Thorax 65(Suppl 1):i1–i58CrossRef
4.
go back to reference Chalmers JD, Hill AT (2013) Mechanisms of immune dysfunction and bacterial persistence in non-cystic fibrosis bronchiectasis. Mol Immunol 55(1):27–34CrossRef Chalmers JD, Hill AT (2013) Mechanisms of immune dysfunction and bacterial persistence in non-cystic fibrosis bronchiectasis. Mol Immunol 55(1):27–34CrossRef
5.
go back to reference McShane PJ, Naureckas ET, Tino G, Strek ME (2013) Non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 188(6):647–656CrossRef McShane PJ, Naureckas ET, Tino G, Strek ME (2013) Non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med 188(6):647–656CrossRef
6.
go back to reference Shoemark A, Ozerovitch L, Wilson R (2007) Aetiology in adult patients with bronchiectasis. Respir Med 101(6):1163–1170CrossRef Shoemark A, Ozerovitch L, Wilson R (2007) Aetiology in adult patients with bronchiectasis. Respir Med 101(6):1163–1170CrossRef
7.
go back to reference Pasteur MC, Helliwell SM, Houghton SJ, Webb SC, Foweraker JE, Coulden RA, Flower CD, Bilton D, Keogan MT (2000) An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med 162(4 Pt 1):1277–1284CrossRef Pasteur MC, Helliwell SM, Houghton SJ, Webb SC, Foweraker JE, Coulden RA, Flower CD, Bilton D, Keogan MT (2000) An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med 162(4 Pt 1):1277–1284CrossRef
8.
go back to reference Goeminne P, Dupont L (2010) Non-cystic fibrosis bronchiectasis: diagnosis and management in 21st century. Postgrad Med J 86(1018):493–501CrossRef Goeminne P, Dupont L (2010) Non-cystic fibrosis bronchiectasis: diagnosis and management in 21st century. Postgrad Med J 86(1018):493–501CrossRef
9.
go back to reference Onen ZP, Gulbay BE, Sen E, Yildiz OA, Saryal S, Acican T, Karabiyikoglu G (2007) Analysis of the factors related to mortality in patients with bronchiectasis. Respir Med 101(7):1390–1397CrossRef Onen ZP, Gulbay BE, Sen E, Yildiz OA, Saryal S, Acican T, Karabiyikoglu G (2007) Analysis of the factors related to mortality in patients with bronchiectasis. Respir Med 101(7):1390–1397CrossRef
10.
go back to reference Loebinger MR, Wells AU, Hansell DM, Chinyanganya N, Devaraj A, Meister M, Wilson R (2009) Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. Eur Respir J 34(4):843–849CrossRef Loebinger MR, Wells AU, Hansell DM, Chinyanganya N, Devaraj A, Meister M, Wilson R (2009) Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. Eur Respir J 34(4):843–849CrossRef
11.
go back to reference Finklea JD, Khan G, Thomas S, Song J, Myers D, Arroliga AC (2010) Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis. Respir Med 104(6):816–821CrossRef Finklea JD, Khan G, Thomas S, Song J, Myers D, Arroliga AC (2010) Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis. Respir Med 104(6):816–821CrossRef
12.
go back to reference Roberts HJ, Hubbard R (2010) Trends in bronchiectasis mortality in England and Wales. Respir Med 104(7):981–985CrossRef Roberts HJ, Hubbard R (2010) Trends in bronchiectasis mortality in England and Wales. Respir Med 104(7):981–985CrossRef
13.
go back to reference Minov J, Karadzinska-Bislimovska J, Vasilevska K, Stoleski S, Mijakoski D (2015) Assessment of the non-cystic fibrosis bronchiectasis severity: the FACED Score vs the bronchiectasis severity index. Open Respir Med J 9:46–51CrossRef Minov J, Karadzinska-Bislimovska J, Vasilevska K, Stoleski S, Mijakoski D (2015) Assessment of the non-cystic fibrosis bronchiectasis severity: the FACED Score vs the bronchiectasis severity index. Open Respir Med J 9:46–51CrossRef
14.
go back to reference Goeminne PC, Nawrot TS, Ruttens D, Seys S, Dupont LJ (2014) Mortality in non-cystic fibrosis bronchiectasis: a prospective cohort analysis. Respir Med 108(2):287–296CrossRef Goeminne PC, Nawrot TS, Ruttens D, Seys S, Dupont LJ (2014) Mortality in non-cystic fibrosis bronchiectasis: a prospective cohort analysis. Respir Med 108(2):287–296CrossRef
15.
go back to reference Martínez-García M, de Gracia J, Vendrell Relat M, Girón RM, Máiz Carro L, de la Rosa Carrillo D, Olveira C (2014) Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score. Eur Respir J 43(5):1357–1367CrossRef Martínez-García M, de Gracia J, Vendrell Relat M, Girón RM, Máiz Carro L, de la Rosa Carrillo D, Olveira C (2014) Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score. Eur Respir J 43(5):1357–1367CrossRef
16.
go back to reference Puéchal X, Génin E, Bienvenu T, Le Jeunne C, Dusser DJ (2014) Poor survival in rheumatoid arthritis associated with bronchiectasis: a family-based cohort study. PLoS ONE 9(10):e110066CrossRef Puéchal X, Génin E, Bienvenu T, Le Jeunne C, Dusser DJ (2014) Poor survival in rheumatoid arthritis associated with bronchiectasis: a family-based cohort study. PLoS ONE 9(10):e110066CrossRef
17.
go back to reference Ellis HC, Cowman S, Fernandes M, Wilson R, Loebinger MR (2016) Predicting mortality in bronchiectasis using bronchiectasis severity index and FACED scores: a 19-year cohort study. Eur Respir J 47(2):482–489CrossRef Ellis HC, Cowman S, Fernandes M, Wilson R, Loebinger MR (2016) Predicting mortality in bronchiectasis using bronchiectasis severity index and FACED scores: a 19-year cohort study. Eur Respir J 47(2):482–489CrossRef
18.
go back to reference Goeminne PC, Scheers H, Decraene A, Seys S, Dupont LJ (2012) Risk factors for morbidity and death in non-cystic fibrosis bronchiectasis: a retrospective cross-sectional analysis of CT diagnosed bronchiectatic patients. Respir Res 13:21CrossRef Goeminne PC, Scheers H, Decraene A, Seys S, Dupont LJ (2012) Risk factors for morbidity and death in non-cystic fibrosis bronchiectasis: a retrospective cross-sectional analysis of CT diagnosed bronchiectatic patients. Respir Res 13:21CrossRef
19.
go back to reference Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, Poppelwell L, Salih W, Pesci A, Dupont LJ, Fardon TC, De Soyza A, Hill AT (2014) The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med 189(5):576–585CrossRef Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, Poppelwell L, Salih W, Pesci A, Dupont LJ, Fardon TC, De Soyza A, Hill AT (2014) The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med 189(5):576–585CrossRef
20.
go back to reference Jacques PS, Gazzana MB, Palombini DV, Barreto SS, Dalcin PT (2012) Six-minute walk distance is not related to quality of life in patients with non-cystic fibrosis bronchiectasis. J Bras Pneumol 38(3):346–355CrossRef Jacques PS, Gazzana MB, Palombini DV, Barreto SS, Dalcin PT (2012) Six-minute walk distance is not related to quality of life in patients with non-cystic fibrosis bronchiectasis. J Bras Pneumol 38(3):346–355CrossRef
21.
go back to reference Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246(3):697–722CrossRef Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246(3):697–722CrossRef
22.
go back to reference Keistinen T, Säynäjäkangas O, Tuuponen T, Kivelä SL (1997) Bronchiectasis: an orphan disease with a poorly understood prognosis. Eur Respir J 10(12):2784–2787CrossRef Keistinen T, Säynäjäkangas O, Tuuponen T, Kivelä SL (1997) Bronchiectasis: an orphan disease with a poorly understood prognosis. Eur Respir J 10(12):2784–2787CrossRef
23.
go back to reference Martinez-Garcia MA, Soler-Cataluna JJ, Perpina-Tordera M, Roman-Sanchez P, Soriano J (2007) Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis. Chest 132(5):1565–1572CrossRef Martinez-Garcia MA, Soler-Cataluna JJ, Perpina-Tordera M, Roman-Sanchez P, Soriano J (2007) Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis. Chest 132(5):1565–1572CrossRef
24.
go back to reference Davies G, Wells AU, Doffman S, Watanabe S, Wilson R (2006) The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis. Eur Respir J 28(5):974–979CrossRef Davies G, Wells AU, Doffman S, Watanabe S, Wilson R (2006) The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis. Eur Respir J 28(5):974–979CrossRef
Metadata
Title
Prognostic Factors in Adult Patients with Non-Cystic Fibrosis Bronchiectasis
Authors
Betina Charvet Machado
Patrícia Santos Jacques
Louise Piva Penteado
Paulo de Tarso Roth Dalcin
Publication date
01-12-2018
Publisher
Springer US
Published in
Lung / Issue 6/2018
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-018-0165-z

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