FACTORS AFFECTING MORTALITY AND MORBIDITY IN PATIENTS WITH BRONCHIECTASIS

Abstract

OBJECTIVE: Recurrent bronchial infections lead to a decrease in pulmonary function and an increase in mortality and morbidity in patients with bronchiectasis. We aimed to evaluate mortality rate and identify risk factors in mortality in patients with bronchiectasis.MATERIAL AND METHODS: In this study the records of 104 patients who underwent high resolution computed tomography (HRCT) were evaluated. Demographic variables, symptoms, physical examination findings, HRCT and pulmonary function test (PFT), culture and sputum analysis results, antibiotic resistance, infection markers, need to stay in intensive care unit and mortality rates were examined.RESULTS: The mean age was 59.5±15.1 years. Sputum production was detected in 65.4% of the cases and in 27.9% a microorganism was identified on sputum culture. Antibiotic resistance was detected in 11.5% of the cases. Infection episode, antibiotic resistance, age, smoking and respiratory insufficiency were associated with mortality (p<0.05 for all). A significant difference was noted in FEV1% between patients with and without antibiotic resistance (p<0.05). There was negative association between FEV1 and antibiotic resistance (r=-0.257, p=0.02), respiratory insufficiency (r=-0.288, p=0.01) and infection episodes (r=-0.329, p=0.003). Number of infection episode was higher in patients with a FEV1 <60% (p=0.003). Pulmonary hypertension was detected in 21.2% of the patients which was significantly more common in tubular and bilateral bronchiectasis.CONCLUSIONS: Older age, smoking, infection episode, respiratory insufficiency and antibiotic resistance were associated with an increased risk of mortality. Our findings indicate that antibiotic resistance should be determined in patients with bronchiectasis who have a FEV1 value <60% as these cases have increased mortality.