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      Thrombocytosis during Stable State Predicts Mortality in Bronchiectasis.

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          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.

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          Author and article information

          Journal
          Ann Am Thorac Soc
          Annals of the American Thoracic Society
          American Thoracic Society
          2325-6621
          2325-6621
          Aug 2021
          : 18
          : 8
          Affiliations
          [1 ] Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Pneumologia, Milan, Italy.
          [2 ] Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
          [3 ] Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari-Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy.
          [4 ] Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland.
          [5 ] Hospital Universitari Vall d'Hebron, Barcelona Institut de Recerca Vall d'Hebron, CIBER, Barcelona, Spain.
          [6 ] Servei de Pneumologia, Hospital Clinic, Universidad de Barcelona, IDIBAPS CIBERES, Barcelona, Spain.
          [7 ] AZ Nikolaas, Sint-Niklaas, Belgium.
          [8 ] 5th Respiratory Department, "Sotiria" Chest Diseases Hospital, Athens, Greece.
          [9 ] Pulmonology Institute and CF Center, Carmel Medical Center and the B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
          [10 ] Respiratory Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
          [11 ] Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
          [12 ] Tayside Respiratory Research Group, University of Dundee, Dundee, United Kingdom; and.
          [13 ] School of Medicine, University of Milan Bicocca, AO San Gerardo, Monza, Italy.
          Article
          10.1513/AnnalsATS.202002-094OC
          33507847
          13d196e2-4ab5-4df8-b763-ea9878603a4d
          History

          bronchiectasis,mortality,platelets
          bronchiectasis, mortality, platelets

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