Thrombocytosis during Stable State Predicts Mortality in Bronchiectasis.

Abstract

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.

• Authors: Stefano Aliberti, Giovanni Sotgiu, Andrea Gramegna, Melissa J McDonnell, Eva Polverino, Antoni Torres, Pieter C Goeminne, Katerina Dimakou, Michal Shteinberg, Oriol Sibila, Valentina Conio, Thomas C Fardon, Robert Rutherford, Simone Dore, Laura Saderi, Paola Faverio, Francesco Amati, Angelo G Corsico, Francesco Blasi, James D Chalmers
• Journal: Annals of the American Thoracic Society (Ann Am Thorac Soc) Vol. 18 Issue 8 Pg. 1316-1325 (08 2021) ISSN: 2325-6621 [Electronic] United States
• PMID: 33507847 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Bronchiectasis (complications)
• Female
• Hospitalization
• Humans
• Male
• Quality of Life
• Severity of Illness Index
• Thrombocytosis (epidemiology)