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Introduction: Bronchiectasis exacerbations are a major cause of morbidity and often lead to hospitalisations which are associated with high costs. Yet, disease factors associated with length of stay are not known. Aim: To elucidate factors associated with increased length of hospital stay for exacerbations of bronchiectasis. Method: A retrospective observational study of patients presenting to Changi General Hospital Singapore between 2010-2017 with hospitalised exacerbation of bronchiectasis. Length of stay was modelled using binary logistic regression. Results: 148 patients, age 63±9y, 84(56.8%) male. In univariate analyses, factors associated with longer hospital stay were similar for length of stay >3days, >5days and >7days (BMI, oxygen saturation (SaO2), respiratory rate (RR), C-reactive protein, procalcitonin, total WBC, FEV1 %predicted). On multivariate analyses, BMI(OR:0.90, 95%CI 0.83-0.99,p=0.02), SaO2(OR:0.68, 95%CI 0.53-0.88,p≤0.01), RR (OR:1.41, 95%CI 1.07-1.85,p=0.01) and total WBC(OR:1.16, 95%CI 1.02-1.33,p=0.03) were independently associated with hospital stay >3d; BMI(OR:0.82, 95%CI 0.70-0.96,p=0.01) and RR(OR:1.77, 95%CI 1.10-2.86,p=0.02) for >5d; and procalcitonin (OR:8.53, 95%CI 1.08-67.1,p=0.04) for >7d. Procalcitonin ≥0.25ng/ml was associated with sensitivity of 0.79 and specificity of 0.84 in identifying length of stay >7d (area under the receiver operating characteristics curve 0.81, 95%CI 0.68-0.95,p≤0.01). Conclusions: While BMI, RR, SaO2, are associated with length of stay, their significance decreases as length of stay increases. Procalcitonin, on the other hand, is associated with longer lengths of stay (>7d) for hospitalised bronchiectasis exacerbations. |
