Pectoralis Muscle Area as a Predictor of Mortality in Patients Hospitalized with Bronchiectasis Exacerbation

Respiration. 2024;103(5):257-267. doi: 10.1159/000538091. Epub 2024 Mar 18.

Abstract

Introduction: Data on factors related to mortality in patients with bronchiectasis exacerbation are insufficient. Computed tomography (CT) can measure the pectoralis muscle area (PMA) and is a useful tool to diagnose sarcopenia. This study aimed to evaluate whether PMA can predict mortality in patients with bronchiectasis exacerbation.

Methods: Patients hospitalized due to bronchiectasis exacerbation at a single center were retrospectively divided into survivors and non-survivors based on 1-year mortality. Thereafter, a comparison of the clinical and radiologic characteristics was conducted between the two groups.

Results: A total of 66 (14%) patients died at 1 year. In the multivariate analysis, age, BMI <18.4 kg/m2, sex-specific PMA quartile, ≥3 exacerbations in the previous year, serum albumin <3.5 g/dL, cystic bronchiectasis, tuberculosis-destroyed lung, and diabetes mellitus were independent predictors for the 1-year mortality in patients hospitalized with bronchiectasis exacerbation. A lower PMA was associated with a lower overall survival rate in the survival analysis according to sex-specific quartiles of PMA. PMA had the highest area under the curve during assessment of prognostic performance in predicting the 1-year mortality. The lowest sex-specific PMA quartile group exhibited higher disease severity than the highest quartile group.

Conclusions: CT-derived PMA was an independent predictor of 1-year mortality in patients hospitalized with bronchiectasis exacerbation. Patients with lower PMA exhibited higher disease severity. These findings suggest that PMA might be a useful marker for providing additional information regarding prognosis of patients with bronchiectasis exacerbation.

Keywords: Bronchiectasis exacerbation; Computed tomography; Hospitalization; Mortality; Pectoralis muscles.

MeSH terms

  • Aged
  • Bronchiectasis* / diagnostic imaging
  • Bronchiectasis* / mortality
  • Disease Progression*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Pectoralis Muscles* / diagnostic imaging
  • Prognosis
  • Retrospective Studies
  • Sarcopenia / diagnosis
  • Sarcopenia / diagnostic imaging
  • Sarcopenia / mortality
  • Tomography, X-Ray Computed*