Critical care admission trends and outcomes in individuals with bronchiectasis in the UK

Navaratnam, Vidya; Muirhead, Colin R.; Hubbard, Richard B.; De Soyza, Anthony

Abstract

Background: There are limited data on admission trends and outcomes of individuals with bronchiectasis admitted to intensive care (ICU). Using national critical care data, we analysed admissions to ICU and estimated outcomes in terms of mortality in individuals with bronchiectasis and chronic obstructive pulmonary disease (COPD) admitted to ICU.

Methods: Using data from the Intensive Care National Audit and Research Centre, admissions from bronchiectasis and COPD from 1 January 2009 to 31 December 2013 were extracted. Crude admission rates for bronchiectasis and COPD were calculated and Poisson regression was used to estimate unadjusted annual admission rate ratios. We investigated changes to length of stay on ICU, ICU mortality and in-hospital mortality during the study period. We also compared mortality rates in people with bronchiectasis and COPD aged 70 or above.

Results: We found an annual increase of 8% (95% Confidence Interval [CI] 2-15) in the number of ICU admissions from bronchiectasis, whilst the yearly increase in ICU admissions from COPD was 1% (95% CI 0.3-2). ICU and in-hospital mortality was higher in individuals with bronchiectasis compared with those with COPD, especially in people aged 70 years or above.

Conclusion: Admission to ICU in people with bronchiectasis are uncommon, but are increasing in frequency over time, and carries a substantial mortality rate. This needs to be considered allocating health care resources and planning respiratory services.

Citation

Navaratnam, V., Muirhead, C. R., Hubbard, R. B., & De Soyza, A. (2015). Critical care admission trends and outcomes in individuals with bronchiectasis in the UK. QJM: An International Journal of Medicine, 109(8), https://doi.org/10.1093/qjmed/hcv206

• Journal Article Type: Article
• Acceptance Date: Oct 15, 2015
• Publication Date: Nov 17, 2015
• Deposit Date: Jan 26, 2017
• Publicly Available Date: Jan 26, 2017
• Journal: QJM: An International Journal of Medicine
• Print ISSN: 1460-2725
• Electronic ISSN: 1460-2393
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 109
• Issue: 8
• DOI: https://doi.org/10.1093/qjmed/hcv206
• Keywords: chronic obstructive airway disease, care of intensive care unit patient, bronchiectasis, hospital mortality, intensive care, intensive care unit, length of stay, mortality
• Public URL: https://nottingham-repository.worktribe.com/output/766477
• Publisher URL: https://academic.oup.com/qjmed/article-lookup/doi/10.1093/qjmed/hcv206
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in QJM: An International Journal of Medicine following peer review. The version of record Vidya Navaratnam, Colin R. Muirhead, Richard B. Hubbard, Anthony De Soyza; Critical care admission trends and outcomes in individuals with bronchiectasis in the UK. QJM 2015; 109 (8): 523-526. is available online at: https://academic.oup.com/qjmed/article-lookup/doi/10.1093/qjmed/hcv206. doi:10.1093/qjmed/hcv206
• Contract Date: Jan 26, 2017