Characterization of bronchiectasis in the elderly

被引:22
作者
Bellelli, Giuseppe [1 ]
Chalmers, James D. [2 ]
Sotgiu, Giovanni [3 ]
Dore, Simone [3 ]
McDonnell, Melissa J. [4 ]
Goeminne, Pieter C. [5 ]
Dimakou, Katerina [6 ]
Skrbic, Dusan [7 ]
Lombi, Andrea [8 ]
Pane, Federico [8 ]
Obradovic, Dusanka [7 ]
Fardon, Thomas C. [2 ]
Rutherford, Robert M. [4 ]
Pesci, Alberto [8 ]
Aliberti, Stefano [9 ,10 ]
机构
[1] Univ Milano Bicocca, Sch Med & Surg, Geriatr Unit, ASST San Gerardo, Via Pergolesi 33, Monza, Italy
[2] Univ Dundee, Tayside Resp Res Grp, Dundee DD1 9SY, Scotland
[3] Univ Sassarim, Dept Biomed Sci, Res Med Educ & Profess Dev Unit, Clin Epidemiol & Med Stat Unit,AOU Sassari, Sassari, Italy
[4] Galway Univ Hosp, Dept Resp Med, Newcastle Rd, Galway H91 YR71, Ireland
[5] Univ Hosp Gasthuisberg, Resp Med, Herestr 49, B-3000 Leuven, Belgium
[6] Sotiria Chest Hosp, Dept Pulm 5, Athens, Greece
[7] Univ Novi Sad, Inst Pulm Dis Vojvodina Sremska Kamenica, Fac Med, Clin Gen Pulmonol, Novi Sad 21000, Serbia
[8] Univ Milano Bicocca, Sch Med & Surg, AO San Gerardo, Via Pergolesi 33, Monza, Italy
[9] Univ Milan, Cardiothorac Unit, Dept Pathophysiol & Transplantat, Via Francesco Sforza 35, I-20122 Milan, Italy
[10] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Adult Cyst Fibrosis Ctr, Via Francesco Sforza 35, I-20122 Milan, Italy
基金
英国惠康基金; 英国医学研究理事会;
关键词
Frailty; Cystic fibrosis; Pseudomonas; COPD; Comorbidity; VALIDATION; FRAILTY; PREVALENCE; MORTALITY; PEOPLE; COHORT; ADULTS;
D O I
10.1016/j.rmed.2016.08.008
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Introduction: Although bronchiectasis particularly affects people >= 65 years of age, data describing clinical characteristics of the disease in this population are lacking. This study aimed at evaluating bronchiectasis features in older adults and elderly, along with their clinical outcomes. Methods: This was a secondary analysis of six European databases of prospectively enrolled adult outpatients with bronchiectasis. Bronchiectasis characteristics were compared across three study groups: younger adults (18-65 years), older adults (66-75 years), and elderly (and >= 76 years). 3-year mortality was the primary study outcome. Results: Among 1258 patients enrolled (median age: 66 years; 42.5% males), 50.9% were >= 65 years and 19.1 >= 75 years old. Elderly patients were more comorbid, had worse quality of life and died more frequently than the others. Differences were detected among the three study groups with regard to neither the etiology nor the severity of bronchiectasis, nor the prevalence of chronic infection with P. aeruginosa. In multivariate regression model, age (OR: 1.05; p-value: <0.0001), low BMI (OR: 2.63; p-value: 0.02), previous hospitalizations (OR: 2.06; p-value: 0.006), and decreasing FEV1 (OR: 1.02; p-value: 0.001) were independent predictors of 3-year mortality, after adjustment for covariates. Conclusion: Bronchiectasis does not substantially differ across age groups. Poor outcomes in elderly patients with bronchiectasis might be directly related to individual's frailty that should be further investigated in clinical studies. (C) 2016 Elsevier Ltd. All rights reserved.
引用
收藏
页码:13 / 19
页数:7
相关论文
共 26 条
[1]
Clinical phenotypes in adult patients with bronchiectasis [J].
Aliberti, Stefano ;
Lonni, Sara ;
Dore, Simone ;
McDonnell, Melissa J. ;
Goeminne, Pieter C. ;
Dimakou, Katerina ;
Fardon, Thomas C. ;
Rutherford, Robert ;
Pesci, Alberto ;
Restrepo, Marcos I. ;
Sotgiu, Giovanni ;
Chalmers, James D. .
EUROPEAN RESPIRATORY JOURNAL, 2016, 47 (04) :1113-1122
[2]
Anderson G., 2010, Chronic Care
[3]
Using assessing care of vulnerable elders quality indicators to measure quality of hospital care for vulnerable elders [J].
Arora, Vineet M. ;
Johnson, Martha ;
Olson, Jared ;
Podrazik, Paula M. ;
Levine, Stacie ;
DuBeau, Catherine E. ;
Sachs, Greg A. ;
Meltzer, Anddavid O. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 (11) :1705-1711
[4]
Is it time for a "pneumo-geriatrician" for frail old patients with respiratory diseases? [J].
Bellelli, Giuseppe ;
Aliberti, Stefano .
EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2014, 25 (04) :303-303
[5]
Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline [J].
Buurman, Bianca M. ;
Hoogerduijn, Jita G. ;
de Haan, Rob J. ;
Abu-Hanna, Ameen ;
Lagaay, A. Margot ;
Verhaar, Harald J. ;
Schuurmans, Marieke J. ;
Levi, Marcel ;
de Rooij, Sophia E. .
PLOS ONE, 2011, 6 (11)
[6]
Chalmers J.D., 2015, ERJ OPEN RES, V1, P00081
[7]
Management of bronchiectasis in adults [J].
Chalmers, James D. ;
Aliberti, Stefano ;
Blasi, Francesco .
EUROPEAN RESPIRATORY JOURNAL, 2015, 45 (05) :1446-1462
[8]
The Bronchiectasis Severity Index An International Derivation and Validation Study [J].
Chalmers, James D. ;
Goeminne, Pieter ;
Aliberti, Stefano ;
McDonnell, Melissa J. ;
Lonni, Sara ;
Davidson, John ;
Poppelwell, Lucy ;
Salih, Waleed ;
Pesci, Alberto ;
Dupont, Lieven J. ;
Fardon, Thomas C. ;
De Soyza, Anthony ;
Hill, Adam T. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2014, 189 (05) :576-585
[9]
A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[10]
Frailty in elderly people [J].
Clegg, Andrew ;
Young, John ;
Iliffe, Steve ;
Rikkert, Marcel Olde ;
Rockwood, Kenneth .
LANCET, 2013, 381 (9868) :752-762