Managing bronchiectasis: 13 years of experience from sputum to lung transplantation

Abstract

Objectives: Bronchiectasis and especially related mortality has gained growing interest in recent years.The aim of our retrospective study was to determine the factors which may influence and indicate mortality in our bronchiectasis patients throughout 13 years. Material and methods: Patients with ICD-10 code J47 depicting bronchiectasis between 1.1.2003 to 31.12.2015 were evaluated using database of our hospital.694 out of 1470 patients who had high-resolution computed tomography (HRCT) scan confirming the presence of bronchiectatic lesions were included. results: Female/male ratio was 1.09. Mean age of the patients was 45.9 +/- 15.7 years. Sputum culture results were available in 365 (52.6%)of the patients.Pseudomonas aeruginosa was the leading pathogen, which was found in 68 (20.7%) patients.28 (4%) patients have died during the 13 year period, and the overall survival was 125,3 months. In general 5 (4.4%) out of 112 patients who underwent surgery were lost, 3 of them belonging to the transplantation group. 3 out of 9 patients (33%) who underwent lung transplantation were lost within 3 years.There was no statistically significant difference in survival between patients who underwent surgery or not (p>0.05). In univariate Cox regression mortality analysis age, FEV1, P aeruginosa, E.coli, hospitalisation and ICU admission had p value <0.01. When these factors were evaluated in the multivariate analysis, only Paeruginosa reached statistical significance in predicting mortality. Conclusion: Isolation of Paeruginosa in a patient with bronchiectasis should be taken seriously. It can be suggested that eradication treatment according to guidelines will help reduce mortality of bronchiectasis worldwide. Surgery is still an option of treatment in severe bronchiectasis and lung transplantation may be a life-saving way of managing end-stage disease.