医学
血小板增多症
支气管扩张
优势比
置信区间
逻辑回归
混淆
内科学
四分位间距
血小板
胃肠病学
肺
作者
Stefano Aliberti,Giovanni Sotgiu,Andrea Gramegna,Melissa McDonnell,Eva Polverino,Antoni Torres,Pieter Goeminne,Katerina Dimakou,Michal Shteinberg,Oriol Sibila,Valentina Conio,Thomas C. Fardon,Robert Rutherford,Simone Dore,Laura Saderi,Paola Faverio,Francesco Amati,Angelo Corsico,Francesco Blasi,James D. Chalmers
出处
期刊:Annals of the American Thoracic Society
[American Thoracic Society]
日期:2021-08-01
卷期号:18 (8): 1316-1325
被引量:6
标识
DOI:10.1513/annalsats.202002-094oc
摘要
Rationale: Although platelets are considered key inflammatory mediators in respiratory diseases, their role in bronchiectasis has not been fully explored. Objectives: We hypothesized that thrombocytosis in stable state may be associated with bronchiectasis severity and worse clinical outcomes. Methods: Patients with bronchiectasis have been enrolled from 10 centers in Europe and Israel, with platelet count recorded during stable state. The primary outcome was 5-year all-cause mortality. Secondary outcomes included exacerbations, hospitalizations, and mortality at 1, 2, and 3-year follow-up. Analyses were conducted using logistic regression after adjustment for confounding variables. Results: Among the 1,771 patients (median age, 67 yr; 63.4% female) included, 136 (7.7%) had thrombocytosis. Patients with thrombocytosis had a significantly higher disease severity, worse quality of life, higher number of exacerbations and hospitalizations, and higher mortality rate at both 3-year (23 [22.8%] vs. 83 [8.5%], respectively; P < 0.01) and 5-year (26 [35.1%] vs. 116 [15.9%], respectively; P < 0.01) in comparison with those with normal platelet count. Thrombocytosis was significantly associated with hospitalizations because of severe exacerbations (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.20-2.79; P = 0.01) after 1-year follow-up, as well as increased 3-year (OR, 3.06; 95% CI, 1.74-5.39; P < 0.01) and 5-year (OR, 2.46; 95% CI, 1.39-4.37; P < 0.01) mortality. Conclusions: Platelets represent a cheap and easy-to-evaluate biomarker, and the presence of thrombocytosis during stable state is associated with disease severity, hospitalizations because of exacerbations, poor quality of life, and mortality in adults with bronchiectasis.