Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Am J Med Sci. 2023 Jun;365(6):502-509. doi: 10.1016/j.amjms.2023.03.009. Epub 2023 Mar 15.
Data regarding the clinical characteristics and treatment outcomes of patients with community-acquired pneumonia (CAP) and bronchiectasis (BE) are rare. This study aims to elucidate the clinical relevance of BE in patients with CAP.
Patients hospitalized with CAP in a single center were retrospectively analyzed and divided into significant BE (BE with ≥ 3 lobes or cystic BE on computed tomography) and control groups. Clinical and microbiological characteristics were compared between the two groups.
In the final analysis, 2112 patients were included, and 104 (4.9%) had significant BE. The significant BE group exhibited a higher prevalence of sputum production, dyspnea, and complicated parapneumonic effusion or empyema than the control group. Pseudomonas aeruginosa was more frequently isolated in the significant BE group than in the control group, whereas Mycoplasma pneumoniae was less commonly identified. Length of hospital stay (LOS) was significantly longer in the significant BE group than the control group (12 [8-17] days vs. 9 [6-13] days, p < 0.001). In contrast, 30-day and in-hospital mortality rates did not significantly differ between the two groups. Furthermore, significant BE was an independent predictor of prolonged hospitalization in two models based on CURB-65 and pneumonia severity index.
Significant BE occurred in approximately 5% of patients with CAP and was more likely to be associated with sputum, dyspnea, complicated parapneumonic effusion or empyema, and isolation of P. aeruginosa. Significant BE was an independent predictor of LOS in patients with CAP.
关于社区获得性肺炎（CAP）和支气管扩张症（BE）患者的临床特征和治疗结果的数据很少。本研究旨在阐明 BE 在 CAP 患者中的临床相关性。
回顾性分析单中心住院的 CAP 患者，并将其分为有意义的 BE（CT 上≥3 个肺叶或囊性 BE）和对照组。比较两组患者的临床和微生物学特征。
最终分析纳入 2112 例患者，其中 104 例（4.9%）有显著的 BE。与对照组相比，显著 BE 组咳痰、呼吸困难和并发脓胸或脓胸的发生率更高。与对照组相比，显著 BE 组更常分离出铜绿假单胞菌，而肺炎支原体较少。显著 BE 组的住院时间（LOS）明显长于对照组（12[8-17]天 vs. 9[6-13]天，p<0.001）。然而，两组 30 天和住院死亡率无显著差异。此外，在基于 CURB-65 和肺炎严重指数的两个模型中，显著 BE 是住院时间延长的独立预测因素。
约 5%的 CAP 患者存在显著的 BE，更可能与咳痰、呼吸困难、并发脓胸或脓胸和铜绿假单胞菌分离有关。显著 BE 是 CAP 患者 LOS 的独立预测因素。
