Factors Associated With Long-Term Mortality in Bronchiectasis.

INTRODUCTION There are scarce data on long-term mortality in bronchiectasis in studies including a high number of bronchiectasis subjects. The objective of this study was to investigate risk factors of all-cause mortality in a large series of bronchiectasis patients with a long follow-up.

Methods

Historical cohort series from the Spanish Registry of Bronchiectasis in 2057 patients with a median follow-up of 84 (IQR: 72-102) months. A wide set of data from all the dimensions of bronchiectasis (general, clinical, etiological, complementary test, peripheral biomarkers, functional, microbiological, and therapeutic) was collected. 408 patients died during follow-up. Multivariable Cox survival analysis was used.

Results

Thirteen variables (Condition/HR): COPD/3.16; Chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA)/2.57; peripheral neutrophilia (>80%)/2.53; Previous and follow-up hospitalization rate/2.01 and 1.93 respectively; Previous and follow-up exacerbation rate/1.05 and 2.01 respectively; Charlson index/1.24; age/1.06; Baseline FEV1%pred/0.98; Previous pneumonia episodes/1.04 and dyspnea/1.16 were independently associated with greater mortality. FACED, E-FACED and BSI were analyzed separately, with HR of 2.3, 2.2 and 1.7, respectively.

Conclusions

The presence of COPD, CBI by PA, peripheral neutrophilia, and hospitalizations were the four most important variables independently associated with greater long-term mortality in bronchiectasis.