Abstract
Bronchiectasis is a progressive chronic disease associated with an increased risk of mortality. To identify the prevalence of comorbidities in patients with bronchiectasis and the impact of these comorbidities on mortality. A cohort of 93 patients with computed tomography (CT)-confirmed bronchiectasis admitted consecutively to a tertiary teaching hospital was observed over a period of 5 years. All patients were carefully observed for comorbidities and mortality. A total of 43 men (46.2%) and 50 women (53.8%) with a median age of 66.0 years (interquartile range (IQR) 59.7-74.0 years), and a median of 3 comorbidities at baseline (IQR 1-5) were observed. The mortality rate during the observation period was 16%. The median number of comorbidities was significantly higher in the group of non-survivors (5 (IQR 3-5.75)) compared with survivors (3 (IQR 1-4); p = 0.0100). The burden of comorbidities was associated with an increased hazard of death: having 4 or more comorbidities was associated with an increased risk of death compared to patients with 2 or 3 coexisting illnesses (hazard ratio (HR) = 1.35 (95% confidence interval (95% CI) [0.41, 4.41]); p = 0.0494). The Bronchiectasis Aetiology Comorbidity Index (BACI) was a significant predictor of death in patients with severe bronchiectasis. We found a significant number of comorbidities in patients with bronchiectasis. In these patients, the comorbidity burden has an impact on mortality. The BACI is a useful tool for the clinical assessment of patients with severe bronchiectasis.
Highlights
Bronchiectasis is a progressive chronic disease associated with an increased risk of mortality
The burden of comorbidities was associated with an increased hazard of death: having 4 or more comorbidities was associated with an increased risk of death compared to patients with 2 or 3 coexisting illnesses (hazard ratio (HR) = 1.35 (95% confidence interval [0.41, 4.41]); p = 0.0494)
We found a significant number of comorbidities in patients with bronchiectasis
Summary
Bronchiectasis is a progressive chronic disease associated with an increased risk of mortality. Several prospective studies assessing the survival of patients with non-cystic fibrosis (CF) bronchiectasis have been conducted. Multicenter studies assessing factors affecting mortality allowed for the preparation of complex tools that help in estimating the risk of death. The FACED (FEV1, age, Psedomonas aeruginosa colonisation, radiological extension, and dyspnoea) score[4] and the Bronchiectasis Severity Index (BSI)[5] were generated, and they have proven to be clinically helpful in assessing the individual risk of death. The attention has been directed to the impact of another factor that significantly affects the prognosis of bronchiectasis patients: comorbidities. The occurrence of cardiovascular disease (CVD),[6] infections or kidney diseases,[7] and rheumatological diseases[8] increase the mortality of patients with bronchiectasis
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