Clinical relevance of bronchiectasis in patients with community-acquired pneumonia

• Published in: The American journal of the medical sciences 2023-06, Vol.365 (6), p.502-509
• Main Authors: Seo, Hyewon, Cha, Seung-Ick, Park, Jongmin, Lim, Jae-Kwang, Lee, Won Kee, Park, Ji-Eun, Choi, Sun Ha, Lee, Yong Hoon, Yoo, Seung-Soo, Lee, Shin-Yup, Lee, Jaehee, Kim, Chang-Ho, Park, Jae-Yong
• Format: Article
• Language: English
• Subjects: Bronchiectasis; Bronchiectasis - complications; Bronchiectasis - epidemiology; Clinical Relevance; Community-acquired infections; Community-Acquired Infections - complications; Community-Acquired Infections - drug therapy; Community-Acquired Infections - epidemiology; Empyema; Humans; Pleural Effusion - drug therapy; Pneumonia; Pneumonia - complications; Pneumonia - drug therapy; Pneumonia - epidemiology; Retrospective Studies
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1016/j.amjms.2023.03.009

Data regarding the clinical characteristics and treatment outcomes of patients with community-acquired pneumonia (CAP) and bronchiectasis (BE) are rare. This study aims to elucidate the clinical relevance of BE in patients with CAP. Patients hospitalized with CAP in a single center were retrospectively analyzed and divided into significant BE (BE with ≥ 3 lobes or cystic BE on computed tomography) and control groups. Clinical and microbiological characteristics were compared between the two groups. In the final analysis, 2112 patients were included, and 104 (4.9%) had significant BE. The significant BE group exhibited a higher prevalence of sputum production, dyspnea, and complicated parapneumonic effusion or empyema than the control group. Pseudomonas aeruginosa was more frequently isolated in the significant BE group than in the control group, whereas Mycoplasma pneumoniae was less commonly identified. Length of hospital stay (LOS) was significantly longer in the significant BE group than the control group (12 [8–17] days vs. 9 [6–13] days, p < 0.001). In contrast, 30-day and in-hospital mortality rates did not significantly differ between the two groups. Furthermore, significant BE was an independent predictor of prolonged hospitalization in two models based on CURB-65 and pneumonia severity index. Significant BE occurred in approximately 5% of patients with CAP and was more likely to be associated with sputum, dyspnea, complicated parapneumonic effusion or empyema, and isolation of P. aeruginosa. Significant BE was an independent predictor of LOS in patients with CAP.