FACTORS INFLUENCING HOSPITALIZATION OF PATIENTS WITH BRONCHIECTASIS EXACERBATIONS: A COHORT STUDY

Background: In bronchiectasis, exacerbations have been associated with higher mortality and a greater impairment of lung function. This study aims to evaluate factors associated with exacerbations requiring hospitalization, with regard to host characteristics, usual treatments, severity and history of exacerbations and to assess the etiology of bronchiectasis. Methods: This prospective observational cohort study was conducted among patients with a compatible clinical history consistent of chronic sputum production and/or frequent respiratory infections with confirmed findings of bronchiectasis by HRCT of lungs performed prior to study recruitment. Minimum sample size required for the study was 72. This cohort consisted of 77 patients who were followed up for 1year and separated in two subsets: patients treated as outpatients and those admitted to hospital at least once during the follow-up. Results: Among the participants, 37 (48.1%) were hospitalized in 1 year follow up period whereas 40 (51.9%) were not hospitalized during the period. All of the patient required hospitalization due to exacerbation were above 50 years. Vaccinated patients were more among OP Patients.29 out of 37 Patients shows any one of culture isolate, from which 32.4% were pseudomonas, 18.9 % were MDR pathogen 27% were other organism. IP Cohort more than half of the patient shows FEV1 less than 50. For OP cohort the entire patient shows FEV1 above 50 with significant P value. Bronchiectasis exacerbation (BE) patients with higher BSI and FACED scores required more hospital admissions because of exacerbation. Conclusion: Age, Forced Expiratory Volume in 1 second (FEV1), extent of radiological involvement, coexistent COPD, exacerbation in last 1 year, culture isolation of organism, use of Proton Pump Inhibitors (PPI) and Bronchiectasis Severity (BSI) score were found to be risk factors for exacerbation. Pneumococcal and Influenza vaccination is found to be a protective factor.