Impact of bronchiectasis severity on clinical outcomes in patients with allergic bronchopulmonary aspergillosis: a retrospective cohort study
Abstract
BACKGROUND
The impact of bronchiectasis severity on the outcomes of patients with allergic bronchopulmonary aspergillosis (ABPA) remains uncertain.
OBJECTIVE
To evaluate whether bronchiectasis severity is associated with an increased risk of ABPA exacerbations.
METHODS
We retrospectively analyzed ABPA patients between 2007 and 2019. Patients were categorized based on the segments involved by bronchiectasis as mild (1-5), moderate (6-9), and extensive (≥10). We compared lung function and immunological markers among the groups. A multivariable Poisson regression analysis, using follow-up duration as an offset variable, assessed the association between bronchiectasis severity and ABPA exacerbations, adjusting for key confounders. We report the association as an adjusted relative rate (aRR) with 95% confidence intervals (CI).
RESULTS
We included 705 ABPA patients (mean age, 35 years). Of these, 219 (31.1%), 226 (32.1%), and 260 (36.9%) had mild, moderate, and extensive bronchiectasis. Patients with extensive bronchiectasis had poorer lung function and elevated immunological markers (serum total IgE, A.fumigatus-IgE, and -IgG) than those with mild or moderate bronchiectasis. The exacerbation frequency increased with the severity of bronchiectasis (mild: 41.5% vs. moderate: 53.4% vs. extensive: 57.7%, p=0.005). On multivariable analysis, the risk of ABPA exacerbation increased significantly with bronchiectasis severity (aRR [95% CI]; extensive:1.51 [1.09-2.08], moderate: 1.50…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 705 participants or records.
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