Al-Harbi Abdullah, Al-Ghamdi Majed, Khan Mohammad, Al-Rajhi Sulaiman, Al-Jahdali Hamdan
College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.
Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
Int J Chron Obstruct Pulmon Dis. 2020 Sep 14;15:2157-2165. doi: 10.2147/COPD.S261797. eCollection 2020.
The aim of this study was to assess the clinical characteristics and outcomes of patients with post-tuberculosis (post-TB) bronchiectasis. We also evaluated the performance of various multidimensional severity score systems to predict mortality, future exacerbation, and hospitalization.
We conducted a prospective observational cohort study to evaluate the etiology of bronchiectasis in 301 patients. Patients fell into three groups: post-TB (129 [43%]), idiopathic (76 [25%]), and other (96 [32%]) etiologies of bronchiectasis. Four multidimensional grading scales, including the Bronchiectasis Severity Index (BSI), the FACED score, and two derivative versions of the FACED score, Exacerbation (Exa-FACED and E-FACED), were calculated and compared for each patient.
Patients with post-TB bronchiectasis were predominantly female (61%) with a mean age of 68±11 years. Moreover, 26% of post-TB bronchiectasis patients were colonized with . At baseline, patients with post-TB bronchiectasis were older, had higher severity scores, and were more likely to have experienced severe exacerbations that required hospitalization compared to patients with idiopathic bronchiectasis or bronchiectasis arising from other causes. During follow-up, 52% of patients required hospitalization, 58% had frequent (≥2 per year) acute exacerbations, and the overall 5-year mortality rate was 30%. Five-year survival was efficiently predicted by each of the grading scales. Although the modified variations of the FACED outperformed the original FACED scale in predicting forthcoming frequent acute exacerbations and hospitalization, the BSI outperformed all three systems in this regard.
Patients with post-TB bronchiectasis had higher severity scores than patients with idiopathic bronchiectasis or bronchiectasis arising from other causes. In addition, all scoring systems performed adequately in 5-year mortality projections. BSI and the modified versions of the FACED outperformed the FACED in predicting forthcoming exacerbations and hospitalizations.
本研究旨在评估肺结核后支气管扩张患者的临床特征及预后。我们还评估了各种多维严重程度评分系统预测死亡率、未来病情加重及住院情况的效能。
我们开展了一项前瞻性观察性队列研究，以评估301例支气管扩张患者的病因。患者分为三组：肺结核后（129例[43%]）、特发性（76例[25%]）和其他（96例[32%]）支气管扩张病因。为每位患者计算并比较了四个多维分级量表，包括支气管扩张严重程度指数（BSI）、FACED评分以及FACED评分的两个衍生版本，即病情加重版（Exa-FACED和E-FACED）。
肺结核后支气管扩张患者以女性为主（61%），平均年龄为68±11岁。此外，26%的肺结核后支气管扩张患者合并[此处原文缺失内容]。在基线时，与特发性支气管扩张患者或其他原因引起的支气管扩张患者相比，肺结核后支气管扩张患者年龄更大，严重程度评分更高，且更有可能经历需要住院治疗的严重病情加重。在随访期间，52%的患者需要住院治疗，58%的患者有频繁（每年≥2次）急性加重，总体5年死亡率为30%。每个分级量表都能有效预测5年生存率。尽管FACED的改良版本在预测即将发生的频繁急性加重和住院方面优于原始FACED量表，但在这方面BSI优于所有三个系统。
肺结核后支气管扩张患者的严重程度评分高于特发性支气管扩张患者或其他原因引起的支气管扩张患者。此外，所有评分系统在5年死亡率预测方面表现良好。在预测即将发生的病情加重和住院方面，BSI和FACED的改良版本优于FACED。
