Predictors of mortality in hospitalized patients with acute exacerbation of bronchiectasis.
BACKGROUND
In-hospital and long term outcomes of patients admitted to the hospital for acute exacerbation of bronchiectasis (AEB) has been evaluated in only a limited fashion. The resulting debilitation after an AEB can increase mortality. This study aims to evaluate the factors associated with mortality in patients admitted with an acute exacerbation of bronchiectasis (AEB).


METHODS
All charts of the patients admitted between 2003 and 2006 with an AEB were reviewed through an electronic database. Demographics, sputum cultures, pulmonary functions tests and other factors associated with long-term mortality were examined. The social security death index was used to determine long term mortality (http://ssdi.genealogy.rootsweb.com).


RESULTS
Forty-three patients (13 men and 30 women) with a mean age of 71.8+/-11.8 were studied. The hospital mortality was 9% and one-year mortality was 30% with a median survival of 46.6 months. Variables associated with mortality were male gender (female vs. male (HR), 0.36; (CI), 0.14-0.98; p=0.045), use of systemic steroids (with vs. without steroids HR, 3.12; CI 1.08-9.02; p=0.036), decreased FEV(1.0)% predicted (HR, 0.96; CI 0.92-0.999; p=0.042), elevated creatinine (HR, 2.36; CI 1.093-5.10; p=0.029), history of smoking (HR, 0.283; CI 0.097-0.825; p=0.021), and mechanical ventilation (HR, 66.011; CI 6.64-656.76; p=0.0004).


CONCLUSIONS
Male gender, elevated creatinine, decreased FEV(1.0)% predicted, mechanical ventilation, history of smoking, and acute use of systemic steroids during the hospitalization were associated with an increased risk of mortality.
Finklea
James D
JD
Department of Pulmonary, Allergy, and Critical Care Medicine, Emory University Hospital, Atlanta, Georgia, United States.
Khan
Gul
G
Thomas
Sheree
S
Song
Juhee
J
Myers
Dennis
D
Arroliga
Alejandro C
AC
D000368:Aged; D001987:Bronchiectasis / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome