Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080, Republic of Korea.
Kangwon National University College of Medicine, Chuncheon, Republic of Korea.
Respir Res. 2019 Dec 3;20(1):271. doi: 10.1186/s12931-019-1243-3.
All-cause mortality risk and causes of death in bronchiectasis patients have not been fully investigated. The aim of this study was to compare the mortality risk and causes of death between individuals with bronchiectasis and those without bronchiectasis.
Patients with or without bronchiectasis determined based on chest computed tomography (CT) at one centre between 2005 and 2016 were enrolled. Among the patients without bronchiectasis, a control group was selected after applying additional exclusion criteria. We compared the mortality risk and causes of death between the bronchiectasis and control groups without lung disease. Subgroup analyses were also performed according to identification of Pseudomonas or non-tuberculous mycobacteria, airflow limitation, and smoking status.
Of the total 217,702 patients who underwent chest CT, 18,134 bronchiectasis patients and 90,313 non-bronchiectasis patients were included. The all-cause mortality rate in the bronchiectasis group was 1608.8 per 100,000 person-years (95% confidence interval (CI), 1531.5-1690.0), which was higher than that in the control group (133.5 per 100,000 person-years; 95% CI, 124.1-143.8; P < 0.001). The bronchiectasis group had higher all-cause (adjusted hazard ratio (aHR), 1.26; 95% CI, 1.09-1.47), respiratory (aHR, 3.49; 95% CI, 2.21-5.51), and lung cancer-related (aHR, 3.48; 95% CI, 2.33-5.22) mortality risks than the control group. In subgroup analysis, patients with airflow limitation and ever smokers showed higher all-cause mortality risk among bronchiectasis patients. Therefore, we observed significant interrelation between bronchiectasis and smoking, concerning the risks of all-cause mortality (P for multiplicative interaction, 0.030, RERI, 0.432; 95% CI, 0.097-0.769) and lung cancer-related mortality (RERI, 8.68; 95% CI, 1.631-15.736).
Individuals with bronchiectasis had a higher risk of all-cause, respiratory, and lung cancer-related mortality compared to control group. The risk of all-cause mortality was more prominent in those with airflow limitation and in ever smokers.
支气管扩张症患者的全因死亡率和死亡原因尚未得到充分研究。本研究旨在比较支气管扩张症患者和无支气管扩张症患者的死亡率和死亡原因。
在 2005 年至 2016 年期间，在一家中心根据胸部计算机断层扫描（CT）确定有或无支气管扩张症的患者。在无支气管扩张症的患者中，在应用其他排除标准后选择了对照组。我们比较了无肺部疾病的支气管扩张症组和对照组的死亡率和死亡原因。还根据鉴定假单胞菌或非结核分枝杆菌、气流受限和吸烟状况进行了亚组分析。
在总共接受胸部 CT 检查的 217702 名患者中，纳入了 18134 名支气管扩张症患者和 90313 名非支气管扩张症患者。支气管扩张症组的全因死亡率为 1608.8/100000 人年（95%置信区间（CI），1531.5-1690.0），高于对照组（133.5/100000 人年；95%CI，124.1-143.8；P<0.001）。支气管扩张症组的全因（调整后的危险比（aHR），1.26；95%CI，1.09-1.47）、呼吸（aHR，3.49；95%CI，2.21-5.51）和肺癌相关（aHR，3.48；95%CI，2.33-5.22）死亡率均高于对照组。在亚组分析中，有气流受限和既往吸烟者的支气管扩张症患者全因死亡率较高。因此，我们观察到支气管扩张症与吸烟之间存在显著的全因死亡率（P 相乘交互作用，0.030，RERI，0.432；95%CI，0.097-0.769）和肺癌相关死亡率（RERI，8.68；95%CI，1.631-15.736）之间存在显著关联。
与对照组相比，支气管扩张症患者的全因、呼吸和肺癌相关死亡率更高。有气流受限和既往吸烟者的全因死亡率风险更高。
