Onen Zeynep Pinar, Gulbay Banu Eris, Sen Elif, Yildiz Oznur Akkoca, Saryal Sevgi, Acican Turan, Karabiyikoglu Gülseren
Department of Pulmonary Diseases, School of Medicine, Ankara University, Ankara, Turkey.
Respir Med. 2007 Jul;101(7):1390-7. doi: 10.1016/j.rmed.2007.02.002. Epub 2007 Mar 19.
Bronchiectasis is a common disabling but rarely fatal disease. However the long-term prognosis and risk factors for mortality are not well known.
The aim of this study was to determine prospectively the survival and predictive factors of mortality in patients with bronchiectasis, during 4-year follow-up.
From September 2000 to January 2005 survival of bronchiectasis (as evaluated by computed tomography) and predictors of mortality were assessed in 98 outpatients. Fifty-one of the patients had self-reported history of pulmonary infection including tuberculosis. Baseline data, reevaluated in every single year according to scheduled visits.
The mean age was 61+/-10 and 74% of the patients were female. In total, 16 patients (16.3%) died; mean survival time was 44.06+/-1.6 months. The survival rates were 97%, 89%, 76%, 58% at 1, 2, 3 and 4 years, respectively. Cox proportional hazard model revealed that long-term mortality was significantly associated with age, body mass index (BMI), Medical Research Council (MRC) dyspnea scale, vaccination, radiographic extent, hypoxemia, hypercapnia and functional parameters. However, MRC and BMI had more significant effects on the mortality than the functional parameters.
These results suggest that high BMI, regular vaccination and scheduled visits may have beneficial effects on the survival of bronchiectasis. Besides, presence of hypoxemia, hypercapnia, dyspnea level and radiographic extent were more closely correlated with mortality.
支气管扩张是一种常见的致残但很少致命的疾病。然而，其长期预后和死亡风险因素尚不明确。
本研究旨在前瞻性地确定支气管扩张患者在4年随访期间的生存率和死亡预测因素。
2000年9月至2005年1月，对98例门诊患者评估支气管扩张的生存率（通过计算机断层扫描评估）和死亡预测因素。其中51例患者有自我报告的肺部感染病史，包括结核病。根据预定随访每年重新评估基线数据。
平均年龄为61±10岁，74%的患者为女性。共有16例患者（16.3%）死亡；平均生存时间为44.06±1.6个月。1年、2年、3年和4年的生存率分别为97%、89%、76%、58%。Cox比例风险模型显示，长期死亡率与年龄、体重指数（BMI）、医学研究委员会（MRC）呼吸困难量表、疫苗接种、影像学范围、低氧血症、高碳酸血症和功能参数显著相关。然而，MRC和BMI对死亡率的影响比功能参数更显著。
这些结果表明，高BMI、定期疫苗接种和定期随访可能对支气管扩张患者的生存有有益影响。此外，低氧血症、高碳酸血症、呼吸困难程度和影像学范围与死亡率的相关性更强。
