Survival of bronchiectatic patients with respiratory failure in ICU.
BACKGROUND
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. This study aims to identify the in-hospital and long-term outcome of patients with bronchiectasis and respiratory failure (RF) in ICU.


METHODS
A retrospective study was carried out by studying all bronchiectatic patients admitted to the medical ICU for RF over a 10-year period (1995-2004).


RESULTS
The 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.


CONCLUSIONS
The decreased survival of ICU patients was associated with age > 65 years, activity index (bedridden or wheelchair-bound) and use of inotropic support.
Alzeer
Abdulaziz H
AH
Division of Pulmonology, Department of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia. alzeerahm@yahoo.com
Masood
Mohammed
M
Basha
Syed Jani
SJ
Shaik
Shaffi A
SA
D000367:Age Factors; D000368:Aged; D001987:Bronchiectasis / Q000150:complications / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome