UNASSIGNED: Aboriginal Australians residing in the Top End Health Service region of the Northern Territory of Australia aged >18 years with chest computed tomography (CT) confirmed bronchiectasis between 2011 and 2020 were included. Demographics, body mass index (BMI), medical co-morbidities, lung function data, sputum microbiology, chest CT scan results, hospital admissions restricted to respiratory conditions and all-cause mortality were assessed.
UNASSIGNED: A total of 459 patients were included, of whom 146 were recorded deceased (median age at death 59 years). Among the deceased cohort, patients were older (median age 52 vs. 45 years, p = 0.023), had a higher prevalence of chronic obstructive pulmonary disease (91 vs. 79%, p = 0.126), lower lung function parameters (median percentage predicted forced expiratory volume in 1 s 29 vs. 40%, p = 0.149), a significantly greater proportion cultured non-Aspergillus fungi (65 vs. 46%, p = 0.007) and pseudomonas (46 vs. 28%, p = 0.007) on sputum microbiology and demonstrated bilateral involvement on radiology. In multivariate models advancing age, prior pseudomonas culture and Intensive care unit (ICU) visits were associated with increased odds of mortality. Higher BMI, better lung function on spirometry, prior positive sputum microbiology for Haemophilus and use of inhaled long-acting beta antagonist/muscarinic agents may have a favourable effect.
UNASSIGNED: The results of this study may be of use to stratify high risk adult Aboriginal patients with bronchiectasis and to develop strategies to prevent future mortality.
2011年至2020年期间,居住在澳大利亚北领地高端卫生服务区、年龄>18岁、胸部计算机断层扫描(CT)证实支气管扩张的澳大利亚原住民。人口统计,体重指数(BMI),医学合并症,肺功能数据,痰微生物学,胸部CT扫描结果,我们评估了仅限于呼吸系统疾病的住院患者和全因死亡率.
■共纳入459名患者,其中146人死亡(死亡年龄中位数为59岁)。在死者中,患者年龄较大(中位年龄52岁vs.45年,p=0.023),慢性阻塞性肺疾病的患病率较高(91vs.79%,p=0.126),较低的肺功能参数(1秒29预测用力呼气容积的中位数百分比与40%,p=0.149),培养的非曲霉真菌的比例明显更高(65vs.46%,p=0.007)和假单胞菌(46vs.28%,p=0.007)在痰微生物学上,并在放射学上表现出双边参与。在推进年龄的多变量模型中,先前的假单胞菌培养和重症监护病房(ICU)就诊与死亡率增加相关.BMI较高,肺活量测定的肺功能更好,先前对嗜血杆菌呈阳性的痰微生物学和吸入长效β拮抗剂/毒蕈碱类药物的使用可能具有有利作用.
■这项研究的结果可能有助于对支气管扩张的高危成年土著患者进行分层,并制定预防未来死亡的策略。