Giuseppe Bellelli1, James D Chalmers2, Giovanni Sotgiu3, Simone Dore3, Melissa J McDonnell4, Pieter C Goeminne5, Katerina Dimakou6, Dusan Skrbic7, Andrea Lombi8, Federico Pane8, Dusanka Obradovic7, Thomas C Fardon2, Robert M Rutherford4, Alberto Pesci8, Stefano Aliberti9. 1. School of Medicine and Surgery, University of Milan Bicocca, Geriatric Unit, ASST San Gerardo, Via Pergolesi 33, Monza, Italy. 2. Tayside Respiratory Research Group, University of Dundee, Dundee, DD1 9SY, UK. 3. Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassarim, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy. 4. Department of Respiratory Medicine, Galway University Hospitals, Newcastle Road, Galway, H91YR71, Ireland. 5. University Hospital Gasthuisberg, Respiratory Medicine, Herestraat 49, B-3000 Leuven, Belgium. 6. 5th Pulmonary Department, "Sotiria" Chest Hospital, Athens, Greece. 7. Institute for Pulmonary Diseases of Vojvodina Sremska Kamenica, Clinic for General Pulmonology, Faculty of Medicine University of Novi Sad, Serbia. 8. School of Medicine and Surgery, University of Milan Bicocca, AO San Gerardo, Via Pergolesi 33, Monza, Italy. 9. Department of Pathophysiology and Transplantation, University of Milan, Cardio-thoracic Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: stefano.aliberti@unimi.it.
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.
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.
Authors: Katherine O'Neill; Gokul R Lakshmipathy; Curtis Neely; Denise Cosgrove; Kathryn Ferguson; Rebecca McLeese; Adam T Hill; Michael R Loebinger; Mary Carroll; James D Chalmers; Timothy Gatheral; Chris Johnson; Anthony De Soyza; John R Hurst; Ian Bradbury; Joseph S Elborn; Judy M Bradley Journal: Ann Am Thorac Soc Date: 2022-09
Authors: James D Chalmers; Megan Crichton; Pieter C Goeminne; Michael R Loebinger; Charles Haworth; Marta Almagro; Montse Vendrell; Anthony De Soyza; Raja Dhar; Lucy Morgan; Francesco Blasi; Stefano Aliberti; Jeanette Boyd; Eva Polverino Journal: Breathe (Sheff) Date: 2017-09