支气管扩张症患者在 3 年随访期间的死亡率和合并症。

Mortality and comorbidities in patients with bronchiectasis over a 3-year follow-up.

机构信息

Department of Chest Diseases, Rio de Janeiro State University, Pulmonology Service, Rio de Janeiro, Brazil.

Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

出版信息

Medicine (Baltimore). 2022 Dec 30;101(52):e32537. doi: 10.1097/MD.0000000000032537.

Abstract

To identify the risk factors associated with all-cause mortality in patients with noncystic fibrosis bronchiectasis (NCFB). This prospective cohort study included 120 adult patients with NCFB, who were regularly treated at a specialized outpatient clinic of a university hospital between January 2017 and June 2020. All patients were diagnosed using high-resolution computed tomography. Demographic and clinical data, pulmonary function tests, and the Euro-quality-of-life 5-domain 3-level questionnaire were analyzed. The factors associated with death were determined using the Cox proportional hazards model. The all-cause mortality rate at 41 months was 10.8%. Adjusted multivariate analysis showed that the main contributing predictors for mortality were female sex, smoking, diabetes, chronic obstructive pulmonary disease, emergency visits, use of antibiotics due to exacerbation, secretion color change, exacerbation, predicted forced expiratory volume in 1 second, predicted forced vital capacity, lack of respiratory physiotherapy, absence of vaccination against pneumococci, and mobility domain. Multiple factors contribute to unfavorable outcomes in patients with NCFB, and early recognition of these factors may improve care management.

摘要

目的

确定非囊性纤维化支气管扩张症(NCFB)患者全因死亡率的相关危险因素。

方法

这是一项前瞻性队列研究,纳入了 2017 年 1 月至 2020 年 6 月期间在一所大学医院的专门门诊定期接受治疗的 120 例成年 NCFB 患者。所有患者均通过高分辨率计算机断层扫描进行诊断。分析了人口统计学和临床数据、肺功能检查以及欧洲生活质量 5 维度 3 水平问卷。使用 Cox 比例风险模型确定与死亡相关的因素。41 个月时的全因死亡率为 10.8%。调整后的多变量分析表明,死亡的主要预测因素为女性、吸烟、糖尿病、慢性阻塞性肺疾病、急诊就诊、因恶化而使用抗生素、分泌物颜色改变、恶化、预计 1 秒用力呼气量、预计用力肺活量、缺乏呼吸物理治疗、未接种肺炎球菌疫苗以及活动能力维度。

结论

多种因素导致 NCFB 患者预后不良,早期识别这些因素可能有助于改善护理管理。

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