Acute exacerbation in patients with bronchiectasis: What prognostic factors?

Abstract

BACKGROUND: In-hospital and long term outcomes of patients admitted for acute exacerbation of bronchiectasis (AEB) have only been evaluated in a limited fashion. The resulting debilitation after an AEB can increase mortality. This study aims to evaluate the prognostic factors for patients with an AEB. METHODS: Retrospective analyses were conducted for 125 cases of AEB in 48 patients with bronchiectasis, in a pulmonary unit over the period 2010-2015 at Charles Nicolle Hospital in Tunis. Their basic profiles, clinical symptoms and signs, blood tests, sputum culture, dyspnea score and imaging data were analyzed. RESULTS: Mean age was 58.9+/-17.8 years. Sex ratio was 1.52.Bilateral involvement was 64.6%; right/left side ratio according to localization was 1.42. The incidence of recurrence of acute exacerbation was 66% within one year after discharge. The most common reason for AEB was recurrent infection (82.3%). The hospital mortality was 3.1%. Multivariate analysis showed that known bronchiectasis (p=0.007), apyrexia (p=0.033), PH> 7.38 (p=0.046), normal renal function (p=0.043) and White blood cells (p=0.045) were prognostic factors in AEB. Nevertheless, age ≥ 60 years,high dyspnea score, Pseudomonas aeruginosa in sputum culture, chest high-resolution tomography (CT) displayed bronchiectasis involving ≥ 3 lobes were not associated with acute exacerbation of bronchiectasis. CONCLUSIONS: There are multiple prognostic factors of acute exacerbation in patients with bronchiectasis. And their proper identification and management shall improve the prognosis of bronchiectasis patients.