Researchers identified the main variables that impact survival in patients with non-cystic fibrosis bronchiectasis, including age, having more than one disorder, reduced partial oxygen pressure, pulmonary hypertension, and Pseudomonas aeruginosa (P. aeruginosa) infection.
Results of the study, “The factors affecting survival in patients with bronchiectasis,” were published in the Turkish Journal of Medical Sciences.
Limited research has been done on the survival and mortality of patients with non-cystic fibrosis bronchiectasis. This study was designed to target patients who are most likely to benefit from the many new therapies currently under development for the disease.
The team conducted a retrospective analysis of 56 patients (27 men and 29 women) identified in a local Turkish hospital. Data was collected at the time of initial diagnosis and for up to eight years of follow-up. Diagnoses of bronchiectasis were determined by high-resolution computed tomography (HRCT). Cases of cystic fibrosis were excluded from the study.
In addition to general history and demographics, factors and areas of analysis taken into consideration were pulmonary function tests and blood gases, location and extent of affected area, incidence of co-existing disorders, bacterial sputum cultures, types of treatment undergone, smoking status, and vaccinations. Two groups were compared in the analysis: those who survived vs. those who did not.
Results showed that after approximately 5½ years, the overall mortality rate was 35.7%. Not surprisingly, morbidity was higher in patients older than age 65.
Significant correlations were found between mortality and partial oxygen pressure, as well as in pulmonary artery pressure from patients’ first visit to their final one. In contrast, the study showed that the radiological extent of the disease was not directly related to survival.
While four strains of bacterium were cultured, only P. aeruginosa was significantly correlated to the mortality rate. This is not surprising, as prior research indicated that P. aeruginosa is associated with worsened disease severity, airway obstruction, and quality of life.
Comorbidities were analyzed using an index designed to evaluate the risk of multiple diseases and morbidity. Simultaneous diseases occurring with bronchiectasis also decrease survival, according to this measure.
“Bronchiectasis is a disease with high mortality. Advanced age, comorbid conditions, reduced partial oxygen pressure, pulmonary hypertension, and Pseudomonas aeruginosa proliferation in sputum increase its mortality rate,” the authors concluded in their report.
Among factors that did not contribute to morbidity were smoking status, vaccinations, and treatment regimens.
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