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中国一家三级医院支气管扩张症急性加重后一年内再入院的危险因素:一项回顾性队列研究

Risk factors for readmission within one year after acute exacerbations of bronchiectasis in a Chinese tertiary hospital: a retrospective cohort study.

作者信息

Fan Yaxin, Su Ben, Zhang Huiyong, Yang Xiaoyu, Zhang Zhengyi, Zhang Shaoyan, Zhang Shunxian, Wu Dingzhong, Zheng Peiyong, Lu Zhenhui, Qiu Lei

机构信息

Institute of Respiratory Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, No.725 South Wanping Road, No.7 building, Xuhui District, Shanghai, 200032, People's Republic of China.

出版信息

BMC Pulm Med. 2024 Dec 18;24(1):616. doi: 10.1186/s12890-024-03402-1.

Abstract

BACKGROUND

Frequent exacerbations of bronchiectasis lead to poor quality of life, impaired lung function, and higher mortality rates. This study aims to evaluate the risk factors associated with readmission within one year due to acute exacerbation of bronchiectasis (AEB).

METHODS

A retrospective cohort study was performed on 260 patients with bronchiectasis who were hospitalized in the respiratory and critical care department of a tertiary hospital in China. Univariate and multivariate Cox analyses were used to evaluate the risk factors for readmission within one year.

RESULTS

Readmission within one year was found in 44.6% of 260 patients hospitalized with acute exacerbation of bronchiectasis. The risk factors associated with readmission included age over 65 years (HR = 3.66; 95% CI: 2.30 to 5.85), BMI < 18.5 kg/m (HR = 1.71; 95% CI: 1.16 to 2.51), respiratory intensive care unit (RICU) stay during admission (HR = 2.06, 95% CI: 1.16-3.67), involvement of 3 or more lobes on chest high-resolution computed tomography (HRCT) (HR = 1.85; 95% CI, 1.22 to 2.80), chronic Pseudomonas aeruginosa (PA) colonization (HR = 2.29; 95% CI: 1.54 to 3.38), and positive sputum culture results within 24 h after admission (HR = 1.93; 95% CI: 1.27 to 2.94). Long-term oral antibiotics use after discharge was associated with decreased hazard of readmission (HR = 0.34; 95% CI: 0.20 to 0.59).

CONCLUSIONS

Patients with bronchiectasis have a high rate of readmission, which is linked to varieties of risk factors, and identifying these risk factors is importance for effectively managing patients with bronchiectasis.

摘要

背景

支气管扩张症频繁急性加重会导致生活质量下降、肺功能受损及死亡率升高。本研究旨在评估支气管扩张症急性加重(AEB)导致患者一年内再次入院的相关危险因素。

方法

对中国一家三级医院呼吸与重症医学科收治的260例支气管扩张症患者进行回顾性队列研究。采用单因素和多因素Cox分析评估一年内再次入院的危险因素。

结果

260例因支气管扩张症急性加重住院的患者中,44.6%在一年内再次入院。与再次入院相关的危险因素包括年龄超过65岁(HR = 3.66;95%CI:2.30至5.85)、体重指数(BMI)<18.5 kg/m²(HR = 1.71;95%CI:1.16至2.51)、住院期间入住呼吸重症监护病房(RICU)(HR = 2.06,95%CI:1.16 - 3.67)、胸部高分辨率计算机断层扫描(HRCT)显示累及3个或更多肺叶(HR = 1.85;95%CI,1.22至2.80)、慢性铜绿假单胞菌(PA)定植(HR = 2.29;95%CI:1.54至3.38)以及入院后24小时内痰培养结果为阳性(HR = 1.93;95%CI:1.27至2.94)。出院后长期口服抗生素与再次入院风险降低相关(HR = 0.34;95%CI:0.20至0.59)。

结论

支气管扩张症患者再次入院率较高,与多种危险因素相关,识别这些危险因素对有效管理支气管扩张症患者具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/600d/11657681/55d10e15b2a2/12890_2024_3402_Fig1_HTML.jpg

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