Pneumology Department, Hospital Universitario y Politécnico La Fe / Instituto de Investigación Sanitaria (IIS) La Fe. University of Valencia, Valencia, Spain.
Centro de Investigación Biomédica En Red-Enfermedades Respiratorias (CIBERES, CB06/06/0028), Madrid, Spain.
Respir Res. 2017 Sep 30;18(1):176. doi: 10.1186/s12931-017-0659-x.
Bronchiectasis (BE) is a chronic structural lung disease with frequent exacerbations, some of which require hospital admission though no clear associated factors have been identified. We aimed to evaluate factors associated with hospitalization due to exacerbations during a 1-year follow-up period.
A prospective observational study was performed in patients recruited from specialized BE clinics. We considered all exacerbations diagnosed and treated with antibiotics during a follow-up period of 1 year. The protocol recorded baseline variables, usual treatments, Bronchiectasis Severity Index (BSI) and FACED scores, comorbid conditions and prior hospitalizations.
Two hundred and 65 patients were recruited, of whom 162 required hospital admission during the follow-up period. Independent risk factors for hospital admission were age, previous hospitalization due to BE, use of proton pump inhibitors, heart failure, FACED and BSI, whereas pneumococcal vaccination was a protective factor. The area under the receiver operator characteristic curve (AUC) was 0.799 for BSI model was 0.799, and 0.813 for FACED model.
Previous hospitalization, use of proton pump inhibitors, heart failure along with BSI or FACED scores is associated factors for developing exacerbations that require hospitalization. Pneumococcal vaccination was protective. This information may be useful for the design of preventive strategies and more intensive follow-up plans.
支气管扩张症（BE）是一种慢性结构性肺病，常伴有加重，其中一些需要住院治疗，但尚未确定明确的相关因素。我们旨在评估在 1 年随访期间因加重而住院的相关因素。
对来自专门的 BE 诊所招募的患者进行前瞻性观察性研究。我们考虑了在 1 年随访期间诊断和用抗生素治疗的所有加重。该方案记录了基线变量、常规治疗、支气管扩张严重指数（BSI）和 FACED 评分、合并症和既往住院情况。
共招募了 206 名患者，其中 162 名患者在随访期间需要住院治疗。需要住院治疗的独立危险因素是年龄、既往因 BE 住院、质子泵抑制剂的使用、心力衰竭、FACED 和 BSI，而肺炎球菌疫苗接种是保护性因素。BSI 模型的受试者工作特征曲线下面积（AUC）为 0.799，FACED 模型的 AUC 为 0.813。
既往住院、质子泵抑制剂的使用、心力衰竭以及 BSI 或 FACED 评分是需要住院治疗的加重的相关因素。肺炎球菌疫苗接种具有保护作用。这些信息可能对制定预防策略和更强化的随访计划有用。
