BMJ open 2018 03 148(3) e014613 doi 10.1136/bmjopen-2016-014613
occupies an important niche in the pathogenic microbiome of bronchiectasis. The objective of this study is to evaluate the clinical characteristics and prognostic value ofin Chinese adult patients with bronchiectasis.
This retrospective and follow-up study enrolled 1188 patients diagnosed with bronchiectasis at Shanghai Pulmonary Hospital between January 2011 and December 2012. The patients’ clinical data including anthropometry, clinical symptoms, serum biomarkers, radiographic manifestations and lung function indices were reviewed. The median follow-up duration (IQR) was 44 (40-54) months, during which 289 patients were lost to follow-up. Data from 899 patients were collected and analysed for the outcomes of mortality, annual exacerbation frequency and health-related quality of life.
was isolated from 232 patients, alongside other pathogens such as(n=75) and(n=72). There were 74 deaths (12% of patients with, 7.3% of those without) over the course of the follow-up. The isolation ofwas a risk factor for all-cause mortality (HR, 3.07; 95% CI 1.32 to 7.15) and was associated with high rates of exacerbations (ie, ≥3 exacerbations per year of follow-up) (HR, 2.40; 95% CI 1.20 to 4.79). Patients withalso had worse scores on the Hospital Anxiety and Depression Scale (anxiety, p=0.005; depression, p<0.001), the Leicester Cough Questionnaire (p=0.033) and the modified Medical Research Council scale (p=0.001) compared with those without. CONCLUSIONS
Isolation ofin patients with bronchiectasis is a significant prognostic indicator and should be a major factor in the clinical management of the disease.