Pseudomonas aeruginosa and lung function decline in patients with bronchiectasis
Por:
Martinez-Garcia, MA, Oscullo, G, Posadas, T, Zaldivar, E, Villa, C, Dobarganes, Y, Giron, R, Olveira, C, Maiz, L, Garcia-Clemente, M, Sibila, O, Golpe, R, Rodriguez, J, Barreiro, E, Rodriguez, JL, Feced-Olmos, L, Prados, C, Muriel, A, de la Rosa, D
Publicada:
1 mar 2021
Ahead of Print:
18 abr 2020
Resumen:
Objectives: The objective of this study was to analyse lung function decline over time in bronchiectasis, along with the factors associated with it.
Methods: Spirometry was measured every year in this observational, prospective study in 849 patients from the Spanish Bronchiectasis Registry (RIBRON). The main outcome was the decline in the rate of forced expiratory volume during the first second (FEV1). To be included in this study, patients needed a baseline assessment and at least one subsequent assessment. FEV1 decline was analysed using a mixed-effects linear regression model adjusted for clinically significant variables.
Results: We recruited 849 bronchiectasis patients with at least two annual lung function measurements (follow-up range 1-4 years). A total of 2262 lung function tests were performed (mean 2.66 per patient, range 2-5). Mean baseline FEV1 was 1.78 L (standard deviation (SD) 0.76; 71.3% predicted). Mean age was 69.1 (SD 15.4) years; 543 (64% women. The adjusted rates of FEV1 decline were -0.98% predicted/year (95% confidence interval (CI) -2.41 to -0.69) and -31.6 (95% CI -44.4 to -18.8) mL. The annual FEV1 decline was faster in those patients with chronic bronchial infection by Pseudomonas aeruginosa (-1.37% (52.1 mL) vs -0.37% (-24.6 mL); p < 0.001), greater age, increased number of severe exacer-bations in the previous year and higher baseline FEV1 value.
Discussion: In patients with bronchiectasis, the annual rate of FEV1 decline was -31.6 mL/year and it was faster in older patients and those with chronic bronchial infection by P. aeruginosa, increased number of previous severe exacerbations and higher baseline FEV1 value. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Filiaciones:
Martinez-Garcia, MA:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Oscullo, G:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Posadas, T:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Zaldivar, E:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Villa, C:
Clin Fuensanta, Resp Dept, Madrid, Spain
Dobarganes, Y:
Clin Fuensanta, Resp Dept, Madrid, Spain
Giron, R:
Hosp Princesa, Resp Dept, Madrid, Spain
Olveira, C:
Hosp Reg Malaga, Resp Dept, Malaga, Spain
Maiz, L:
Hosp Ramon & Cajal, Resp Dept, Madrid, Spain
Garcia-Clemente, M:
Hosp Oviedo, Resp Dept, Oviedo, Spain
Sibila, O:
Hosp Santa Creu & Sant Pau, Resp Dept, Barcelona, Spain
Golpe, R:
Hosp Lucus Augusti, Resp Dept, Lugo, Spain
Rodriguez, J:
Hosp San Agustin, Resp Dept, Aviles, Spain
Hosp San Carlos, Resp Dept, Madrid, Spain
Barreiro, E:
Hosp del Mar, Resp Dept, Barcelona, Spain
Rodriguez, JL:
Hosp San Carlos, Resp Dept, Madrid, Spain
Feced-Olmos, L:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Prados, C:
Hosp la Paz, Resp Dept, Madrid, Spain
Muriel, A:
Alcala Univ, Hosp Ramon y Cajal, Biostat Unit, IRYCIS,CIBERESP,Nursery Dept, Madrid, Spain
Alcala Univ, Physiotherapy, Madrid, Spain
de la Rosa, D:
Hosp Plato, Resp Dept, Barcelona, Spain
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Bronze
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