Characterization of bronchiectasis in the elderly. (October 2016)

• Record Type: Journal Article
• Authors: Bellelli, Giuseppe; Chalmers, James D.; Sotgiu, Giovanni; Dore, Simone; McDonnell, Melissa J.; Goeminne, Pieter C.; Dimakou, Katerina; Skrbic, Dusan; Lombi, Andrea; Pane, Federico; Obradovic, Dusanka; Fardon, Thomas C.; Rutherford, Robert M.; Pesci, Alberto; Aliberti, Stefano
• Is Part Of: Respiratory medicine. Volume 119(2016)
• Page Start: 13
• Page End: 19
• Publication Date: 2016-10
• Subjects: Frailty -- Cystic fibrosis -- Pseudomonas -- COPD -- Comorbidity; ABPA Allergic Broncho-Pulmonary Aspergillosis -- BMI body mass index -- BSI Bronchiectasis Severity Index -- BTS British Thoracic Society -- CCI Charlson comorbidity index -- CF cystic fibrosis -- CI confidence intervals -- COPD Chronic Obstructive Pulmonary Disease -- FEV1 forced expiratory volume in the first second -- GERD Gastro-Esophageal Reflux Disease -- HRCT high-resolution computed tomography -- IBD inflammatory bowel disease -- IQR interquartile range -- LTOT long-term oxygen therapy -- m-BSI modified Bronchiectasis Severity Index -- MRC medical research council -- MRSA Methicillin-Resistant S. aureus -- MSSA Methicillin-Susceptible S. aureus -- n number -- OR odds ratios -- SD standard deviation -- SGRQ St. George's Respiratory Questionnaire; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2016.08.008
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: 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. Highlights: Among adult patients with bronchiectasis more than 50% are over 65 years. Oldest patients have an increased comorbidity level, experience a worse quality of life and die more frequently. No age-related differences for bronchiectasis severity, signs/symptoms, systemic flogosis and chronic Pseudomonas infection.