Abstract
BackgroundThe outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature. Managing these patients in the ICU can be challenging because of the complex nature of their disease. This study aims to identify the in-hospital and long-term outcome of patients with bronchiectasis and respiratory failure (RF) in ICU.MethodsA retrospective study was carried out by studying all bronchiectatic patients admitted to the medical ICU for RF over a 10-year period (1995–2004).ResultsThe mean (± standard deviation) age of 35 patients was 63.5 ± 11.7 years and APACHE score was 22.3 ± 7.3. The 4-year mortality was 60%. Among the variables observed, age > 65 years (hazard ratio (HR): 4.15; 95% confidence interval (CI): 3.2–5.1), APACHE II score > 24 (2.6, 95% CI 1.7–3.5), intubation (2.81, 95 %CI 1.9–3.7), inotropic support (2.9, 95% CI 2.0–3.7), Home-O2 (4.0, 95% CI 2.7–5.2) and activity index (4.0, 95% CI 2.8–5.3) were associated with diminished survival in univariate analysis by Cox regression. By long rank test, survival probabilities were significantly low at these strata. Multivariate analysis of Cox proportional hazard model showed that age > 65 years (HR: 5.4, 95% CI 1.9–15.7); activity index (HR: 4.8, 95% CI 1.4–16.6); and inotropic support (HR: 3.8, 95% CI 1.5–10.1) were independently associated with reduced survival.ConclusionThe decreased survival of ICU patients was associated with age > 65 years, activity index (bedridden or wheelchair-bound) and use of inotropic support.
Highlights
The outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature
Age > 65 years (hazard ratio (HR): 4.15; 95% confidence interval (CI): 3.2–5.1), APACHE II score > 24 (2.6, 95% CI 1.7–3.5), intubation (2.81, 95 %CI 1.9–3.7), inotropic support (2.9, 95% CI 2.0–3.7), Home-O2 (4.0, 95% CI 2.7–5.2) and activity index (4.0, 95% CI 2.8–5.3) were associated with diminished survival in univariate analysis by Cox regression
Multivariate analysis of Cox proportional hazard model showed that age > 65 years (HR: 5.4, 95% CI 1.9–15.7); activity index (HR: 4.8, 95% CI 1.4–16.6); and inotropic support (HR: 3.8, 95% CI 1.5–10.1) were independently associated with reduced survival
Summary
The outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature. Managing these patients in the ICU can be challenging because of the complex nature of their disease. Some patients may require intensive care therapy for acute respiratory failure (RF). Such patients may present with advanced RF and require assisted ventilation. Managing these patients in the intensive care unit (ICU) can be challenging because of the complex nature of their disease. Significant airway inflammation [5,6], and a change of chest wall geometry make their weaning from mechan-
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